Legacy Savvis Employees Including - CenturyLink Benefits

Transcription

CenturyLink:
2013 Annual Enrollment Guide
Enrollment begins November 5, 2012 and ends November 21, 2012
Legacy Savvis Employees Including:
• Active
• Long-Term Disability
• COBRA
Pay
Table of Contents
What’s Changing for 2013?.....................................2
General Information................................................. 7
Medical (Including Prescription Drug).................. 18
Quick Glance — Medical Benefit Options.............22
Healthcare Advocacy Services.............................43
Working Spouse/Domestic Partner Surcharge....44
Tobacco-Free Discount.........................................46
Dental.....................................................................47
Vision Care.............................................................50
Flexible Spending Accounts..................................52
Quick Glance — Flexible Spending Accounts.......57
Understanding the Healthcare Accounts.............59
Life and Accident...................................................60
Disability.................................................................69
Commuter Spending Account...............................74
Other Benefits........................................................75
Voluntary Lifestyle Benefits...................................76
Important Things to Know..................................... 77
Use the Tools and Enroll........................................79
Enroll Now in Your 2013 Benefits......................... 81
Glossary of Terms..................................................87
Summary of Benefits and Coverage Availability...89
Important Legal and Required Notices.................90
Quick Reference Chart..........................................97
Frequently Asked Questions.................................99
This document summarizes certain provisions of CenturyLink’s Health Care Plan and the CenturyLink Group Life Insurance Plan (collectively referred to as the “Plan”). For specific employee benefit
plan information, refer to the respective official Plan Documents, including the applicable Summary Plan Description and Summaries of Material Modifications, if any. If there is any conflict between the
terms of the official Plan Documents and this document, the terms of the official Plan Documents will govern. The Plan Administrator has the authority, discretion and the right to interpret and resolve
any ambiguities in the Plan or any document relating to the Plan, to supply omissions and resolve conflicts. Benefits and contribution obligations, if any, are determined by CenturyLink in its sole discretion.
While the Plan has processes in place to prevent errors and mistakes, if a clerical error or mistake happens (however occurring) such error or mistake does not create a right to a Benefit or level of
contribution rate under the Plan. You have an obligation to correct any errors or omissions that come to your attention by calling the CenturyLink Service Center to correct the error or omission.
The Plan Administrator, may adopt, at any time, rules and procedures that it determines to be necessary or desirable with respect to the operation of the Plan. CenturyLink reserves the right to amend
or terminate any or all of the Plans and any or all Benefits provided — with respect to all classes of Participants — and their beneficiaries, without prior notice to or consultation with any Participants and
beneficiaries, subject to applicable law, and the terms of the respective official Plan documents.
Plan coverage is not healthcare advice. Please keep in mind that the sole purpose of the Plan is to provide payment for certain eligible healthcare expenses — not to guide or direct the course of
treatment for any employee, or eligible dependent. If your healthcare provider recommends a course of treatment, be sure to check with the Plan to determine whether or not that course of treatment is
covered under the Plan. However, only you and your healthcare provider can decide what the right healthcare decision is for you. Decisions by a claims administrator or the Plan Administrator are solely
decisions with respect to Plan coverage and do not constitute healthcare recommendations or advice.
Welcome to
Annual Enrollment for 2013
Dear CenturyLink Employee:
IMPORTANT
We are pleased to offer you and your eligible dependents a balanced,
competitive program of valuable benefits for 2013 that will provide choices
in healthcare and protection against the unexpected. We encourage you to
review the information in this guide so you understand what is available and
what choices are best for your situation.
Check the CenturyLink Health and
Life Benefits website and carefully
review your enrollment options. You
will be required to make a positive
election for your 2013 health and
welfare benefits as your 2012
elections will not automatically roll
over to 2013.
Annual Enrollment for 2013 benefits is November 5 to November 21, 2012.
You can review and enroll for your 2013 benefits through the CenturyLink
Health and Life Benefits website at www.centurylinkhealthandlife.com.
The CenturyLink Health and Life Benefits website is intuitive and easy
to use. It will be your primary source for all your health and life benefits
information, not only during enrollment but throughout the year. Enrollment
instructions are shown in this Guide starting on page 79.
You are encouraged to take an active role in managing your health.
Feeling good is all about balance. Being healthy isn’t just about fitness; it’s
also about physical, mental and emotional wellbeing. It is important to you,
your family and CenturyLink to be an informed consumer; considering
your healthcare choices as well as costs. Please take some time to
review your Annual Enrollment materials, and share them with your
family members, so you understand the options that will be available to
you beginning January 1, 2013.
Thank you for your continued support of CenturyLink.
If you are eligible for a Flexible
Spending Account or Dependent
Day Care Flexible Spending Account
(FSA) and you wish to enroll, you
must enter a contribution amount.
As a reminder, FSA enrollment is
not automatic and elections must
be made annually.
If you need help using the website,
Service Center Representatives
can assist you by contacting the
CenturyLink Service Center at
(800) 729-7526 from 8:30 a.m.
to 6:30 p.m. Central time, M-F.
Best Regards,
Marina Pearson
VP Compensation & Benefits
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This information is intended only as a highlight of your health plan benefit options. In the event of a conflict, the terms of the official Plan
Documents will govern. Please note there may be other Plan benefits not shown in this overview or which may have been changed. If you
have questions regarding whether other benefits and coverage may be available, please consult the Summary of Material Modifications
(SMM), the Summary Plan Description, and prior SMMs, or call the claims administrator of the benefit option directly.
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CenturyLink Active Employees
2013 Enrollment Guide | October 2012
1
What’s Changing for 2013?
Enroll on Time and
Online — See Page 81
for Easy Steps
Be sure to enroll using the
CenturyLink Health and Life
Benefits website this fall — www.
centurylinkhealthandlife.com.
It’s fast, easy and the best way to
review, choose or make changes
to your CenturyLink benefits. The
site contains everything you need
to enroll — a summary of what’s
changing, information on your
benefit options and costs, helpful
tools for making your decisions,
links to vendor and carrier
websites and more.
Important: If you don’t have
access to a computer or need
help using the website, Service
Center Representatives can assist
you. Visit the CenturyLink Health
and Life Benefits website at
www.centurylinkhealthandlife.
com or contact the CenturyLink
Service Center at (800) 729-7526
from 8:30 a.m. to 6:30 p.m.
Central time, M-F.
Summary of Changes Effective January 1, 2013
Below is a summary of the 2013 health and life changes. If you have
questions regarding your health or life benefits, call the CenturyLink
Service Center at (800) 729-7526.
1. You Must Actively Enroll in Coverage for 2013
If
you do not make an active election through the CenturyLink Health
and Life Benefits, you will have NO benefits for 2013 other than
company‑provided Basic Life Insurance and AD&D, Short-Term Disability
and Basic Long‑Term Disability. You must enroll in order to be covered
by medical, dental, vision, supplemental life insurance, dependent life
insurance, supplemental AD&D, supplemental LTD, Healthcare FSA and/
or Dependent Day Care FSA.
You will receive a paper Confirmation Statement in December, after
Annual Enrollment ends. Please review this statement carefully. If it is
not accurate, call the CenturyLink Service Center immediately to make
any updates.
2.Summary of Benefits and Coverage Availability
You
may now access a Summary of Benefits and Coverage (SBC)
which summarizes important information about the health plan options
available to you. See page 89 for more information.
3.New Health and Life Benefits Website
You
may enroll for your 2013 benefits through the CenturyLink Health
and Life Benefits Website, www.centurylinkhealthandlife.com. Use
the website to review your benefit options and paycheck contributions,
compare your healthcare options and make your 2013 elections. Contact
the CenturyLink Service Center at (800) 729-7526 if you have questions
or need help enrolling. See detailed online enrollment instructions on
page 81.
4.Dependent Eligibility
Under
your CenturyLink benefits, you are not required to cover your
domestic partner in order to cover your domestic partner’s children. For
more information about dependent eligibility requirements, see page 12.
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5.New Medical Benefit Options
You
have three medical benefit plan options for 2013. Your choices include
a High Deductible Health Plan (HDHP) with an optional Health Savings
Account (HSA) and a Preferred Provider Organization (PPO) option.
A new option for Savvis employees will be a Consumer Driven Health
Plan (CDHP) with a Health Reimbursement Account (HRA). Generally,
the same types of benefit services and supplies will be covered under
each plan, but with different deductibles, copays, etc. Refer to the Quick
Glance charts beginning on page 22 to see the differences summarized.
Depending on where you live, you could have claims administered by
UnitedHealthcare, Medica or Highmark (Blue Cross Blue Shield).
Notable
changes:
—— If you have an existing Health Savings Account (HSA) through UHC it
will still be available through OptumHealth Bank; however, CenturyLink
will not provide an employer contribution. If you choose to elect the
High Deductible Health Plan with HSA you will fund the HSA with your
own contributions up to IRS limits.
—— Company contributions are available if you select the new Consumer
Driven Health Plan (CDHP) with Health Reimbursement Account (HRA).
The HRA is similar to an HSA as it pays your eligible out-of-pocket
healthcare expenses tax-free; however, there are key differences. See
page 59 for details.
6.Contribution Changes
You
should be aware of changes to your monthly premium contributions
for medical and dental coverage. In addition, your premium contribution
for CenturyLink Medical coverage will be based on your salary band.
Paycheck contributions are taken over 26 pay periods. Contribution
amounts for each benefit plan option can be found on the CenturyLink
Health and Life Benefits website.
7.PPO Medical Plan — Change in Cost-Sharing
Under
all medical benefit options generally, the cost of major illnesses
and injuries is paid for by CenturyLink. However, there are expenses that
you have the responsibility to pay for. As costs continue to increase, the
Company must share some of those rising costs with you — in the form of
slightly increased network deductibles and out-of-pocket maximums.
For details, visit the CenturyLink Health and Life Benefits website or the
Quick Glance — Medical Benefit Options on pages 22 and 23 and
the other information available in this Guide.
If you are a COBRA
participant…
Please note that some of the
references and benefit options in
this document are applicable only
to active employees. As a COBRA
participant, you may be eligible
for the following benefit options:
Medical/Prescription Drug, Dental
and Vision.
For specific information, refer
to the CenturyLink Health
com. You may also contact the
CenturyLink Service Center at
(800) 729-7526 if you have
any questions.
IF YOU ARE AN ACTIVE
EMPLOYEE AND YOU DON’T
ENROLL BY THE ENROLLMENT
DEADLINE, YOU WILL HAVE ONLY
company-provided benefits of
Basic Life, Accidental Death and
Dismemberment and Disability
insurance coverage. You will NOT
be enrolled in medical, dental,
vision, supplemental life, dependent
life, supplemental AD&D,
supplemental LTD or FSA. You will
not be able to make a change until
the next Annual Enrollment, unless
you have a Qualified Life Event.
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8.Surcharge for Working Spouse/Domestic
Partner
If
your spouse/domestic partner has coverage available through his/
her employer but enrolls in a CenturyLink medical benefit plan option,
a working spouse/domestic partner surcharge of $50 per pay period is
added to your medical premium. See page 44 for details.
9.Tobacco-Free Discount
CenturyLink
offers a 7.5 percent tobacco-free discount on the cost of
your medical premium deductions. The tobacco-free discount is only
available if you and all your dependents covered under your medical
benefit option are tobacco free or enrolled in a tobacco cessation
program. For more information, see page 46.
10.Waiver of Medical Rebate
If
you waive CenturyLink coverage and will be enrolled in coverage
under another employer’s plan that does not permit you to receive a
premium credit for declining coverage, you will be able to waive your
CenturyLink premium credit. Contact the CenturyLink Service Center
at (800) 729-7526 for assistance with a premium waiver request.
11. Wellness Incentives
A
new wellness benefit program will be introduced in 2013 encouraging
you to focus on health and well being. Look for information in the
first quarter about who will be eligible for new programs and related
incentives. The annual health assessment and biometric testing will be
scheduled for the second quarter.
12.Upcoming Transition to OptumRx
In
mid-2013, UHC is transitioning its prescription drug services to
OptumRx, a UnitedHealth Group company. You can expect a smooth
transition and consistent service during this transition, as well as access
to a full range of benefits and support. See additional information on
page 36.
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13.Preventive Care for Women
In
2013, there will be expanded 100 percent coverage for certain
preventive care services — in compliance with Health Care Reform.
Similar to other types of preventive care, these services and supplies
will be covered at 100 percent. See additional information on page 41.
14.Dental Plan Options
You
will have two dental plan options for 2013 that provide benefits
for a basic or enhanced level of care. Each option has different
premium contribution amounts. MetLife administers the new options.
You will have 100 percent preventive care coverage under both dental
options. Depending on which plan you choose, you may have to pay
a percentage of the cost of your dental care. Coverage under the
Aetna DMO that is currently available to Savvis employees will end on
December 31, 2012. For more information, see page 47.
15.Vision Plan Option
CenturyLink
offers vision coverage through the Vision Service Plan. You
pay a copay for eye exams and covered services for eligible dependents
whom you enroll in the vision plan. See page 50 for more information.
16.New Healthcare Flexible Spending Account
(FSA) Limit
Under
Health Care Reform, new IRS limits for Healthcare FSAs will take
effect for 2013. The new annual contribution limit for the Healthcare FSA
is $2,500.
17.New Limited Healthcare FSA
If
you enroll in the High Deductible Health Plan with Health Savings
Account (HDHP with HSA), you have the option of contributing to a
Limited Healthcare FSA to help pay for dental and vision expenses
only. Like a traditional FSA, you can make before‑tax automatic payroll
contributions of up to $2,500 to a Limited Healthcare FSA, if applicable.
See page 52 for details.
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PLEASE NOTE: In selecting
your coverage and advising of
your eligibility and the eligibility
of your dependents, you are
held to the standard of honesty
and truthfulness. Falsifying or
omitting information in enrolling
for coverage under the Plan will
be subject to disciplinary action,
up to and including termination. If
you have questions about whether
your responses in the enrollment
process are accurate, please call
the CenturyLink Service Center.
18.Life Insurance Elections during Annual Enrollment
As
a Legacy Savvis employee, you have a one-time opportunity during
Annual Enrollment for 2013 benefits to elect Supplemental Life insurance
coverage at certain levels without requiring Evidence of Insurability (EOI)
approval. See page 60 for details.
19.Disability Plan Coverage and Options
CenturyLink
offers basic Company-paid short-term and long-term
disability coverage.
Major
features and changes include:
—— STD benefit amount is 70%
—— STD elections are on a before- or after-tax basis
—— CenturyLink provides an allowance equal to the cost of your
STD premium
—— Basic LTD (Company-provided) benefit amount is 50%
—— Supplemental LTD (employee-paid) benefit amount is 65%
—— Change in medical and life insurance benefits during LTD
Short-term
disability is administered by an outsourced vendor,
CenturyLink Disability Services. Long-term disability is administered by
Standard Insurance Company. More information about your disability
plan coverage and options begins on page 69.
20.New Commuter Spending Account Administrator
For
2013, UHC will replace ADP as the administrator of Commuter
Spending Accounts. See page 74 for more information.
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General Information
Eligible dependents include your:
Legacy Savvis Employees:
Spouse
For 2013 Annual Enrollment, you
will not be required to submit
documentation to certify the
eligibility of any dependents you
are currently covering under
the Savvis healthcare and life
insurance plans, provided that
these dependents meet the
eligibility requirements of the
CenturyLink healthcare and life
insurance plans.
— person to whom you are legally married;
Same-sex
or opposite-sex domestic partner — provided you certify (by
completing a Domestic Partner Certification form) that you and your
partner are: each other’s sole domestic partner and intend to remain so
indefinitely; are not related by blood; are not legally married to any other
person; are at least 18 years of age; are mentally competent to consent
to the domestic partnership; and are financially interdependent and have
resided together continuously for at least 12 months prior to applying for
coverage and intend to continue to reside together indefinitely;
Common
law spouse — Only allowable in the following states, according
to the criteria listed below. Note: Your relationship must have begun in a
state that recognizes common law marriage.
—— Alabama
—— Colorado
—— Georgia (if created before 1/1/97)
—— Idaho (if created before 1/1/96)
—— Iowa
You will be required to
verify eligibility for any new
dependents you add to your
coverage. A “new” dependent is
any dependent who is not currently
enrolled in a benefit plan option
but is being added to one or more
of your benefit plan options during
Annual Enrollment.
—— Kansas
—— Montana
—— Ohio (if created before 10/10/91)
—— Oklahoma (if created before 11/1/98)
—— Pennsylvania (if created before 1/1/05)
—— Rhode Island
—— South Carolina
—— Texas
—— Utah
—— Washington, D.C.
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General Information
Note: A new spouse or domestic partner can only be covered if you
complete, in a timely manner, the dependent verification process. You
will be required to submit an affidavit and other verification documents
to validate your relationship status with your dependents. If you fail to
complete and submit the necessary documentation, your dependent(s)
will be removed retroactive to the effective date and you will be
responsible for reimbursement of claims paid under the Plan.
Disabled
dependent — An unmarried child who is determined by
the Health Plan (Claims Administrator) to be indefinitely incapable of
self‑support and fully dependent on the participant for support.
Note: If you remove your disabled dependent from coverage, he or she
will not be eligible for coverage under the Plan, and you will not be able
to reinstate this coverage.
Your
children, up to the end of the month in which he or she attain
age 26. Children include:
—— Your natural children
—— Your legally adopted children including children who are legally
placed for adoption. In the case of a pending adoption, the effective
date is the placement date in the home.
—— Stepchildren
—— Foster children
—— Children of your domestic partner (natural, legally adopted or placed
for adoption or foster children).
Note: You are not required to cover your domestic partner in order
to cover your domestic partner’s children
—— Children for whom you are appointed legal guardian or permanent
legal custody by a court of law, such as grandchildren, nieces or
nephews
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General Information
—— Unmarried children who turn age 26 while covered under the plan
and who continue to depend on you for support because of a physical
handicap that occurred prior to the age of 26, or who are incapable of
self-support due to mental disability, mental illness or developmental
disability — where the condition occurred prior to the age of 26;
(Note: Subject to administrative approval by the Health Plan (Claims
Administrator). Contact the CenturyLink Service Center within
45 days prior to your child’s 26th birthday for details and forms.)
—— Children under a Qualified Medical Child Support Order
(QMCSO) — coverage will be provided to any of your dependent
child(ren) if a Qualified Medical Child Support Order (QMCSO) is
issued, regardless of whether the child(ren) currently resides with
you. A QMCSO may be issued by a court of law or issued by a
state agency as a National Medical Support Notice (NMSN), which
is treated as a QMCSO. If a QMCSO is issued, the child or children
shall become an alternate recipient who is treated as covered under
the Plan and subject to the limitations, restrictions, provisions and
procedures, same as all other Plan participants.
A dependent child covered by the Plan under a QMCSO cannot
be removed from coverage unless there is written authorization
of release from the issuing authority, authorized court of law or
authorized state agency.
If you remove a dependent covered under a QMCSO during any
Annual Enrollment period, the Plan will reinstate the dependent
and you will be responsible for any applicable premiums and all
retroactive premiums in the form of a lump sum, if applicable.
Note: If you have currently waived healthcare coverage under the
Plans, and the QMCSO requires your dependent child(ren) to be
covered, you will be automatically set up with default coverage (PPO
Medical and Basic Dental). You will have healthcare deductions at the
employee & child(ren) coverage level retroactive to the effective date
of the QMCSO/NMSN.
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General Information
Dual Coverage by Plan Participants
CenturyLink benefit plan provisions prohibit any individual from being enrolled
in dual coverage in the Company’s medical, dental, vision, dependent
Supplemental Life and Supplemental AD&D benefit plan options. These
provisions mean that:
CenturyLink
employees cannot elect coverage for themselves while
being enrolled as a qualified dependent under another CenturyLink
employee’s coverage; and
Two
CenturyLink employees cannot enroll the same qualified dependent
in coverage separately.
If
you elect coverage during Annual Enrollment, and are also
covered under the same Plan(s) as a dependent on another
employee’s/retiree’s coverage, your coverage will be corrected once
the enrollment period ends. You will remain in coverage under your
own record, but you will be removed as a dependent from the other
employee’s/retiree’s coverage.
Dual Coverage Option for Child Supplemental Life
Co-employed spouses/domestic partners who wish to have Supplemental
Life coverage for their children must select which employee will hold the
coverage for each child.
If you have any questions contact the CenturyLink Service Center
at (800) 729-7526.
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General Information
Coverage Categories
You may choose among the following coverage categories for each of the
healthcare benefit options (medical/prescription drug, dental and vision):
Employee
only
Employee
& Spouse/Domestic Partner
Employee
& Child(ren)
Employee
& Family (consisting of a Spouse/Domestic Partner and one or
more dependents)
Who You Cannot Cover
The following is a non-exhaustive list of several of the more common
person(s) whom you cannot cover under your CenturyLink benefits program
(and the list is subject to change):
Common
law spouses, unless recognized by the employee’s state of
residence; documentation will be required for approval;
Ex-spouses,
regardless of Divorce Decree or Court Orders;
Parents,
grandparents, aunts, uncles, brothers, sisters, cousins, nieces,
nephews (nieces and nephews may be covered if you have legal
guardianship or permanent legal custody and they live with you in a
parent-child relationship);
Grandchildren
or other children who are not your natural, adopted
or foster children, and for whom you have not been appointed legal
guardian or permanent legal custody; and
Any
other person who does not qualify as an eligible dependent
as defined by the Plan.
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General Information
Adding Dependents During Annual Enrollment
You and your dependents may be eligible for coverage under the
CenturyLink Health Care and Group Life Insurance Plans (collectively
referred to as the “Plan”).
To cover a newly eligible dependent under the Plan, you must verify
that he or she is eligible. An eligible dependent is a dependent who
meets the eligibility requirements under the Plan. You will be required
to provide documentation that supports his or her eligibility under the
Plan. A Dependent Verification packet will be sent to you automatically
in January 2013.
How Do I Verify My Eligible Dependent(s)?
If you add a dependent to the Plan during Annual Enrollment or following a
Qualified Life Event (QLE), you are required to verify that your dependents
are eligible for coverage according to the requirements stated in the Plan.
This step ensures that CenturyLink spends healthcare and life insurance
benefit dollars wisely and can continue to provide benefits to eligible
participants, today and in the future.
Coverage for dependents will become effective prior to completion of
the verification process. However, for each newly added dependent you
would like to cover, you must provide proof of relationship, (i.e., spouse,
child and stepchild, etc.) and financial interdependency (i.e., spouse,
common‑law spouse and domestic partner).
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General Information
Time-Sensitive Deadline to Verify Your Dependents!
Once you enroll your newly added dependent(s), you will receive a verification
kit. You will need to complete a Dependent Verification Form for each
newly added dependent.
Note: If your completed verification documentation is not received in a
timely manner by the CenturyLink Service Center, your dependent(s) will be
removed from coverage retroactive to the date they were added and you
will be responsible for any claims that were incurred during the period in
which your newly added dependent(s) were not verified. Applicable benefit
premium adjustments will be processed after the verification process
is completed. There could be a slight delay in receiving a retro credit, if
applicable, due to the payroll schedule and processing.
To view the eligibility documentation required, go to the CenturyLink Health
and Life Benefits website at www.centurylinkhealthandlife.com. Click
on the Knowledge Center tab, then on Plan Information. Scroll down
to Dependent Verification Documents Required. You can also sign on
through single sign on through the intranet on HRLink.
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General Information
Ending Coverage for Dependents Who
No Longer Meet Eligibility Requirements
If a dependent covered under the Plan no longer meets the eligibility
requirements for coverage, you are responsible for contacting the
CenturyLink Service Center at (800) 729-7526 within 45 days to terminate his
or her coverage. In some cases, you may have the opportunity to continue
healthcare coverage for the formerly eligible dependent under COBRA
(as long as you notify the CenturyLink Service Center within 60 days of
the change). You also have the option of continuing any supplemental life
insurance coverage currently in place for your dependent by converting to an
individual policy. More details are available through the CenturyLink Health
and Life Benefits website at www.centurylinkhealthandlife.com or the
CenturyLink Service Center at (800) 729-7526.
Note — divorce or death of a spouse/domestic partner or child:
Coverage will retroactively end on the last day of the month from the
date of the event, regardless of the notification date. In the event of a
divorce, you will be responsible for any claims paid after eligibility ceased.
If applicable, there could be a slight delay in receiving a retroactive credit
due to payroll processing.
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General Information
Changing Coverage During the Year
After Annual Enrollment ends, if you have a change in your family status
that allows for a change in your benefits, you have 45 days from the date
of the event to make allowable changes to your benefits.
Qualified Life Events (QLE) examples:
Marriage;
Divorce;
Birth
or adoption of a child;
Loss
of other coverage due to termination of your spouse’s/domestic
partner’s employment;
Significant
cost curtailment or change in healthcare coverage
attributable to your spouse’s or domestic partner’s employment;
Learning
that your coverage under another employer’s plan does not
permit you to receive CenturyLink’s waived medical rebate credit;
Loss
of Medicare, Medicaid or CHIP coverage;
Entitlement
to Medicare, Medicaid or CHIP coverage;
Your
dependent no longer qualifies as an eligible dependent due to
exceeding the age limit;
You
or your spouse/domestic partner gain or lose eligibility for coverage;
Death
of a spouse/domestic partner or child.
If you do not notify the CenturyLink Service Center within 45 days (or
60 days if the event is subject to CHIPRA) from the date of the qualifying
status change, you will not be allowed to make changes until the next
Annual Enrollment period. Additionally, if the Qualified Life Event was a
COBRA event, your dependent will lose the opportunity to elect COBRA
if you do not notify the CenturyLink Service Center within 60 days of the
qualifying event. For more information on COBRA, refer to page 96.
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General Information
Please read your Confirmation Statement when it arrives in the
mail in December
Please review this statement carefully and if it is not accurate, call the
CenturyLink Service Center immediately to make any updates.
If you have a Qualified Life Event before 2013
If you make changes during the Annual Enrollment period and have a
subsequent change to your coverage before the end of 2012 (for example,
adding a dependent to coverage because of a Qualified Life Event), you will
need to update your 2012 and 2013 coverage with the CenturyLink Service
Center.
IMPORTANT: Your 2012 changes/enrollment will not automatically be
applied to 2013. You may experience an impact to your paycheck for
applicable retroactive benefit premium deductions.
Choosing a Medical Plan
The CenturyLink Health and Life Benefits website
www.centurylinkhealthandlife.com provides healthcare cost and
estimating tools to help you make informed decisions about choosing
and using the benefits that are best for you and your eligible dependents.
On the site, you can:
Find
out what’s new or changing in your benefits for 2013.
Estimate
and compare what you might pay out-of-pocket for medical
services in 2013.
Compare
the costs of deductibles, copayments, coinsurance, and other
details of the benefit plan options.
Find
out if your doctor or other medical provider participates in the
benefit plan option you are considering.
Estimate
your contribution needs for either the Healthcare or Dependent
Day Care FSA with this helpful tool.
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General Information
Claims and Appeals
Claims and appeals relating to enrollment in a benefit plan option or change
in benefit plan options must be submitted in writing using a Claim Initiation
Form, which can be requested through the CenturyLink Service Center.
In most cases, claims and appeals are reviewed within 30 days of receipt.
Additional time may be requested to review appeals. If additional time
is required, you will be notified. Call the CenturyLink Service Center at
(800) 729-7526 for further assistance or ask additional questions regarding
the claims and appeals process. If an appeal is approved on a retroactive
basis, you may experience retroactive premium deductions on your
paycheck in one lump sum deduction.
Decisions Concerning the Plan
Claims and appeals are reviewed and decisions are made based on
benefit plan provisions. The Claims Administrators, the Benefits Appeals
Committee and the Plan Administrator have each been delegated the sole
and absolute discretion to make decisions with respect to questions and
requests related to the benefits under the Plan. This includes but is not
limited to interpretation of the Plan document and determination of eligibility
for benefits.
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17
Medical (Including
Prescription Drug)
CenturyLink offers you and your eligible dependents three medical benefit
plan options:
PPO
— Preferred Provider Organization option
CDHP
— Consumer Driven Health Plan option
HDHP
— High Deductible Health Plan option
You may also elect to waive medical coverage (including prescription drug
coverage) under CenturyLink and receive an annual waive medical rebate of
$750 paid evenly over 26 pay periods. To waive coverage and receive the
rebate, you must complete the enrollment process and make an affirmative
election to waive medical coverage during the enrollment period. You will
not be eligible for the rebate if you are covered under another CenturyLink
employee or retiree’s medical record as a covered dependent. Refer to the
CenturyLink Couples/Duplicate Coverage for exclusions and exceptions to
receiving the waive medical rebate.
Please review your Confirmation Statement carefully after Annual
Enrollment ends. If it is not accurate, call the CenturyLink Service
immediately to make any updates.
Who Pays Medical Claims?
The medical benefit plan options offered by CenturyLink are self-funded,
which means you (through payroll deductions) and the Company (through
general assets) pay for healthcare services. Self-funding medical coverage
helps ensure that everyone who elects to participate has access to
healthcare, and can help control costs by eliminating charges from outside
insurance carriers.
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Medical (Including
Prescription Drug)
Medical Plan Claims Administrators
For all CenturyLink employees, the Company uses three different Claims
Administrators to administer our medical benefit plan options. For 2013,
the medical Claims Administrators are as follows:
For This
Option...
The Plan Claims
Administrator Is...
If You Live In...
PPO
Highmark
Blue Cross Blue Shield
California, Idaho, Indiana, Michigan,
Montana, New Jersey, North Carolina,
North Dakota, Ohio, Oregon, Pennsylvania,
South Carolina, South Dakota, Tennessee,
Virginia, Washington and Wyoming
PPO
Medica
Western Wisconsin and Minnesota
PPO
UnitedHealthcare
All Other States
CDHP
Medica
North Dakota, South Dakota, Minnesota
and western Wisconsin
CDHP
UnitedHealthcare
All other states
HDHP
Medica
North Dakota, South Dakota, Minnesota
and western Wisconsin
HDHP
UnitedHealthcare
All other states
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19
Medical (Including
Prescription Drug)
Coordinating Medical Claims
The CenturyLink medical benefit options coordinate benefits with other
group health plans (including Medicare) to cover you and your enrolled
dependents. That means your CenturyLink medical coverage and other
group health benefit options work together to pay covered expenses.
Coverage, however, is non-duplicative. So, if you have coverage under
more than one group health plan in addition to your CenturyLink Plan, the
CenturyLink Plan, together with payments from other group health plans,
will never pay more than what you would have received if your CenturyLink
coverage was your only health plan.
If the CenturyLink Plan is primary (the first to pay), benefits will be paid as
if no other group health plan exists.
If the CenturyLink Plan is secondary (the second to pay), benefits will
be reduced by the benefits paid by the primary plan. Benefits from your
CenturyLink Plan will be paid to the extent that, when benefits from both
plans are added together, the total is not more than what the CenturyLink
Plan would have paid if you had no other coverage from another group
health plan.
Note: Each year, your medical benefit plan option Claims Administrator may
require you to complete a Coordination of Benefits (COB) questionnaire,
either online or by paper. Please be sure to fill out this form when requested
to avoid any delay in your claims being paid.
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Medical (Including
Prescription Drug)
Example of Coordinating Claims
Assuming the annual deductible has been met and the CenturyLink Medical Plan pays 80 percent when
using a network provider, here’s how benefits would be calculated if CenturyLink were coordinating
benefits with another group plan. In this example, “The Plan” refers to CenturyLink.
Step 1: Calculate primary payment
Provider charge...................................$1,000
The Plan would have paid....................x 80%
..............................................................$800
Step 2: If other insurance paid less
Step 2: If other insurance paid more
The Plan would have paid.......................$800
Other insurance paid...............................$600
The Plan would pay the difference..........$200
The Plan would pay....................................$0
Step 2: If other insurance paid the same
The Plan would pay...................................$0
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21
Quick Glance –
Medical Benefit Options
Quick Glance — Medical Benefit Options
PPO
Network
$500/person
$1,000/family
Out-of-Network
$1,500/person
$3,000/family
Annual Outof-Pocket
Maximum
(combined for
Network and
Out-of-Network
expenses)
$2,500/person
$5,000/family
Includes
Deductible
(copays
do not apply to outof-pocket max)
$4,000/person
$8,000/family
Includes
Deductible
(charges above
allowable amount
not included)
Coordination of
Benefits
Non-duplication method
Choice of
Doctor/Facility
May use any doctor/facility; however,
plan pays higher benefits with network
providers, no primary care physician or
referrals required
referrals required
referrals required
Preventive
Services
100% preventive
care benefits
Not covered
100% preventive
care benefits
Not covered
100% preventive
care benefits
Not covered
Plan Generally
Pays
80% after
deductible
and/or copay
60% of allowable
amount after
deductible
80% after
deductible
60% of allowable
amount after
deductible
80% after
deductible
and/or copay
60% of allowable
amount after
deductible
You Generally
Pay
20% coinsurance
after deductible
and applicable
copay
40% coinsurance
(after deductible)
and charges over
allowable amount
or not paid by plan
20% coinsurance
after deductible
40% coinsurance
(after deductible)
and charges over
allowable amount
or not paid by plan
20% coinsurance
after deductible
40% coinsurance
(after deductible)
and charges over
allowable amount
or not paid by plan
Annual
Deductible
CDHP
Network
Out-of-Network
Total Deductible (HRA + Member
Responsibility):
$1,500/employee
(includes $1,000 HRA allocation)
$2,250/employee and spouse/DP
$2,250/employee and child(ren)
$3,000/family
HDHP
Network
$1,500/single
coverage
$3,000/two or
more enrolled
$2,000/employee
$3,000/employee
and spouse/DP
$3,000/employee
and child(ren)
$4,000/family
Includes
Deductible
$3,000/single
coverage
$6,000/two or
more enrolled
Includes
Deductible
$2,500/employee
$3,750/employee
and spouse/DP
$3,750/employee
and child(ren)
$5,000/family
Includes
Deductible
(charges above
allowable amount
not included)
Out-of-Network
$3,000/single
coverage
$6,000/two or
more enrolled
$6,000/single
coverage
$12,000/two or
more enrolled
Includes
Deductible
(charges above
allowable amount
not included)
Note: “Charges above allowable amounts not included” refers to reasonable and customary charges (R&C).
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Quick Glance –
Medical Benefit Options
Office Visit
PPO
Network
PCP (primary care
doctor) 100% after
$25 copay
Specialist 100%
after $40 copay
Out-of-Network
Plan pays 60% of
allowable amount
after deductible
CDHP
Network
Plan pays 80%
after deductible
Out-of-Network
Plan pays 60% of
allowable amount
after deductible
HDHP
Network
Plan pays 80%
after deductible
Out-of-Network
Plan pays 60% of
allowable amount
after deductible
(deductible does
not apply)
Urgent Care
100% after
$35 copay
Plan pays 60% of
allowable amount
after deductible
Plan pays 80%
after deductible
Plan pays 60% of
allowable amount
after deductible
Plan pays 80%
after deductible
Plan pays 60% of
allowable amount
after deductible
Inpatient
(Facility)
Plan pays 80%
after deductible
Plan pays 60% of
allowable amount
after deductible
Plan pays 80%
after deductible
Plan pays 60% of
allowable amount
after deductible
Plan pays 80%
after deductible
Plan pays 60% of
allowable amount
after deductible
Outpatient
(Facility)
Plan pays 80%
after deductible
Plan pays 60% of
allowable amount
after deductible
Plan pays 80%
after deductible
Plan pays 60% of
allowable amount
after deductible
Plan pays 80%
after deductible
Plan pays 60% of
allowable amount
after deductible
Emergency
Room
Plan pays 80%
after deductible
Plan pays network
level if emergency;
otherwise 60% of
allowable amount
after deductible
Plan pays 80%
after deductible
Plan pays network
level if emergency,
otherwise 60% of
allowable amount
after deductible
Plan pays 80%
after deductible
Plan pays network
level if emergency,
otherwise 60% of
allowable amount
after deductible
Claims
Procedure
No claims to file
You may need to
file claims
No claims to file
You may need to
file claims
No claims to file
You may need to
file claims
Prescriptions
See Prescription Drug Coverage section
for details
Administered by UnitedHealthcare
80% after deductible network;
60% after deductible out-of-network
Prescriptions are paid the same
as any other medical expense
under the CDHP and apply toward
out-of-pocket maximum.
80% after deductible network;
60% after deductible out-of-network
Prescriptions are paid the same
as any other medical expense
under the CDHP and apply toward
Note: This chart is only a summary of your benefits. For specific details on how services are covered, please
contact your medical Claims Administrator (UHC, Medica or Highmark).
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23
Medical (Including
Prescription Drug)
The Preferred Provider Organization (PPO)
The PPO is a self-funded preferred provider medical benefit option that uses
large networks of doctors, hospitals and other healthcare professionals to
provide services at discounted rates. You also have the flexibility to use
doctors and other professionals who are not part of the network. However,
when you use out-of-network providers, your out-of-pocket costs are
significantly higher. You pay a greater percentage of the bill, plus all charges
above and beyond the reasonable and customary (R&C) amount.
Using PPO Network Providers
Depending on where you live, your PPO option may be administered by
either UnitedHealthcare (including Medica) or Highmark. Both administrators
have large, national networks of doctors, facilities and other healthcare
professionals. The PPO uses these carefully screened groups of physicians,
hospitals, and other healthcare providers to bring you services at competitive
negotiated rates.
Keep in mind that network providers are subject to change based on
participation agreements with the network administrator. You can find a
doctor by using the Find a Doctor tool on the CenturyLink Health and Life
Benefits website at www.centurylinkhealthandlife.com.
Note: if you live outside the PPO network area or outside of the United
States, see the Virtual Network feature described later in this Guide.
The Consumer Driven Health Plan (CDHP)
New for 2013, the CDHP is a self-funded health plan that lets you play
a larger role in how your healthcare dollars are spent by using a health
reimbursement account (HRA) that is funded by the Company. If you don’t
use all the money in your HRA, it also carries over from year to year. But,
there is no interest. If you leave the CDHP and enroll in another medical
benefit plan option, the HRA can only be used for expenses incurred while
you were enrolled in the CHDP.
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Medical (Including
Prescription Drug)
Your CDHP HRA — Automatic and Company
Funded
Under the CDHP option, CenturyLink funds your health reimbursement
account (HRA) during the year, based on your coverage election. You
cannot contribute additional money to the HRA. The HRA is different from
your Healthcare Flexible Spending Account (FSA) and from the new Health
Savings Account (HSA).
HRA Company Contributions
For Employee Only Coverage
For Employee Plus Spouse/
Domestic Partner or Employee
Plus Child(ren) Coverage
For Family Coverage
Company contributes $1,000
To obtain additional information
about your prescription
drug benefits during
Annual Enrollment, go to
http://welcometouhc.com/
centurylink. On and after
January 1, please register or
log on to www.myuhc.com
to review personalized
plan information.
You use the money in your HRA to pay for the full cost of covered medical
expenses you and your dependents (if applicable) incur during the year,
such as office visits, prescriptions and lab tests. For some employees, the
amount the Company puts into the HRA is enough to cover healthcare
and prescription drug expenses for the entire calendar year.
Debit Card Feature
When you enroll in the CDHP, you will receive a UnitedHealthcare (UHC)
debit card, called a Healthcare Spending Card, that works with your HRA.
This allows you to pay eligible healthcare expenses directly from your
HRA, or Healthcare FSA without submitting paper claims. However, if you
choose the HRA option, you will be required to exhaust your HRA balance
before your traditional FSA balance will pay for claims.
Your HRA only reimburses eligible covered medical and prescription
expenses; your traditional Healthcare FSA can reimburse other eligible
medical, prescription drug, dental, vision and certain over-the-counter
(OTC) health items if prescribed by a physician. The debit card can’t be
used to purchase OTC health items that require a prescription. You will be
required to file a paper claim form for reimbursement consideration. Refer
to the FSA section of this Guide for more details.
NOTE: Account balance information for both the HRA and traditional
Healthcare FSA will be loaded onto one card.
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25
Medical (Including
Prescription Drug)
If HRA Funds Are Used Up
If the amount of your medical and prescription drug expenses exceeds
your HRA balance, the CDHP option then switches to the “Member
Responsibility” component, where you must pay a deductible before
benefits are paid. Although you are paying the full cost for services, and/
or prescriptions during this time, you continue to receive the contracted or
network rate if you use in-network providers or pharmacies.
Member Responsibility (You Pay)
For both Employee Plus
Spouse/Domestic Partner
or Employee Plus Child(ren)
Coverage
For Family Coverage
$500
$750
$1,000
Out-of-Pocket Maximum (Includes Member Responsibility and HRA allocation)
For both Employee Plus
or Employee Plus Child(ren)
Coverage
For Family Coverage
$2,000
$3,000
$4,000
Once you have paid the Member Responsibility deductible, the traditional
health coverage component begins paying benefits. You pay a percentage
of the cost of covered services up to an annual out-of-pocket maximum —
after which eligible expenses are covered 100 percent for the rest of the
plan year. The out-of-pocket maximum includes the HRA allocation and
Member Responsibility.
Note: The HRA, Member Responsibility and out-of-pocket maximum are all
based on the coverage level you elect (employee only, employee + family,
etc.) even if only one covered person uses the entire benefit.
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Medical (Including
Prescription Drug)
Money in Your HRA
If you have money left over in your HRA at the end of the year, the balance
rolls over to the next year to help pay for your future healthcare needs.
The HRA rollover is not limited — all remaining HRA dollars roll over to the
next plan year. Your HRA rollover dollars are available on the Healthcare
Spending Card. You can also review your HRA balance by logging on to
www.myuhc.com.
All HRA dollars are forfeited if you terminate your CenturyLink medical
coverage or enroll in another option. If you terminate employment and elect
to continue your CDHP option under COBRA, any remaining HRA balance,
deductible and out-of-pocket maximums from your active plan will continue
under COBRA. If you terminate and are rehired, you will start over as a new
participant with prorated amounts.
The High Deductible Health Plan (HDHP) Option
The HDHP is a self-funded health plan that works similarly to the CDHP
but has some important differences. The HDHP has a higher deductible
than the CDHP. This plan meets IRS requirements for high deductible
health plans, so you have the option of opening a tax-advantaged Health
Savings Account that you can use to save and pay for qualified medical
expenses. The HDHP is administered by UnitedHealthcare and Medica.
Although you have the freedom to choose your healthcare providers, the
plan pays greater benefits when you use providers in the UHC Choice Plus
and Medica Choice Networks.
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27
Medical (Including
Prescription Drug)
How the HDHP Works
Your plan has an annual deductible. The deductible must be paid before your plan will help
pay for eligible healthcare expenses. You do not need to pay anything out-of-pocket for eligible
preventive care services — those services are covered at 100 percent when received in the
network.
When you have an eligible expense, like a doctor visit, the entire cost of the visit will apply to your
deductible. You will pay the full cost of your healthcare expenses until you meet your deductible.
You can choose to pay for care from your HSA or you can choose to pay another way (i.e. cash,
credit card) and let your HSA grow. It’s your money, and your choice.
Once the deductible is paid, the HDHP has coinsurance. With coinsurance, the plan shares the
cost of expenses with you. The HDHP will pay a percentage of each eligible expense, and you
will pay the rest. For example, if your plan pays 80 percent of the cost, you will pay 20 percent.
Once the deductible is met, your plan may have a copayment for certain services, such as
prescription drugs.
An out-of-pocket maximum protects you from major expenses. The out-of-pocket maximum is
the most you will have to pay in the plan year for covered services. If you reach the out-of-pocket
maximum, the HDHP will then pay 100 percent of all remaining covered expenses for the rest of
the plan year. Your deductible, coinsurance and copayments (if they apply) will go toward your outof-pocket maximum.
Step 1: Your deductible
Step 2: Your coverage
You choose to pay out of your pocket
OR with your HSA
Step 3: Your out-of-pocket maximum
The HDHP pays 80% + You pay 20%
Coinsurance
You are protected
When you reach your out-of-pocket
maximum, the plan pays 100%
Preventive care is covered 100% in-network
(As outlined under Healthcare Reform. See page 41 for more information.)
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Medical (Including
Prescription Drug)
Health Savings Account (HSA) — Optional and
Funded by You
If you enroll in the HDHP, you have the option of opening and contributing
to a Health Savings Account (HSA). Unlike the HRA that works with the
CDHP medical benefit plan option, CenturyLink does not contribute to the
HSA. An HSA is a personal bank account that you own. Balances roll over
from year to year, and the HSA starts to earn interest at a certain balance
amount, just like a regular savings account.
You can open an HSA to save and pay for qualified medical expenses, free
from federal taxes. There are no taxes on contributions, interest earned or
expenses paid from the HSA.* When you have medical expenses, including
those that may apply to your annual deductible, you can choose to pay for
them using the money in your HSA. Or, you can save the money for a future
need — even into retirement. It’s your choice.
How to Open an HSA
An HSA can be established with a bank, insurance company or other IRSapproved trustee. If you have an existing HSA with OptumHealth Bank, it
will still be available. If you open your HSA with OptumHealth Bank, you will
receive a Health Savings Account Debit MasterCard®, which makes it easy
to pay from your HSA. There’s no need to write checks and submit claim
forms. HSA transactions and balance information will be accessible through
www.myuhc.com.
If you enroll in the HDHP, the CenturyLink Health and Life Benefits
website will prompt you to decide whether you want to open an HSA
through OptumHealth Bank. You will then be able to make an election
for per‑paycheck contributions to an HSA through OptumHealth Bank.
Automatic payroll contributions are only available for an HSA administered
by OptumHealth Bank.
NOTE: You must have a physical address on file in order to open an HSA
through OptumHealth Bank. A Post Office Box will not be an acceptable
address. You can update your physical address by going to the CenturyLink
Home Page and Selecting ESS/MSS located on the top right hand side of
the screen.
* There are currently three states that require you to pay state income tax on the HSA: Alabama, California and New Jersey.
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29
Medical (Including
Prescription Drug)
Paying for Prescriptions
The HDHP has a combined medical
and prescription drug deductible.
This means that prescription drug
costs will apply to your deductible.
You will pay out-of-pocket for
covered prescriptions and qualifying
medicines until you meet the
deductible. Remember, you
can use your HSA to pay those
expenses. See your Summary
Plan description for details about
prescription drug coverage.
Qualified Medical
Expenses
The IRS decides which expenses
qualify to be paid from an HSA.
You can find a list of common
qualified expenses at
http://welcometouhc.com.
2013 HSA Limits
The IRS limits how much you can
deposit into your HSA each year.
The 2013 limits are:

$3,250
for employee only
coverage

$6,450
for employee plus one or
more dependents coverage
Are You 55 Years Old
or Older?
Until you become eligible for
Medicare, you can deposit an
extra $1,000 during the year. This
is called a catch-up contribution.
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Important Notes:
If
you choose the HDHP and open an HSA, you are ineligible to
participate in any other health plan that is not considered by the
IRS to be a high deductible plan.
You
cannot coordinate benefits with Medicare or other insurance, such
as a spouse’s employer plan, if you are enrolled in an HDHP with an HSA.
If
you incur additional expenses due to non-coordinating benefits, you
may reimburse yourself for these expenses at a later date, once your
HSA has accumulated enough available funds.
You
also have the option to participate in the CenturyLink HDHP and
not open an HSA. But you won’t have the savings and tax advantages
of an HSA.
An HSA Can Work With a Flexible Spending Account
The IRS allows tax advantages for an HSA in a way that is similar to a
Healthcare Flexible Spending Account. Both let you pay for a range of
health expenses tax-free. The big advantage of the HSA is that there isn’t
a “use it or lose it” rule like there is with FSAs.
If you contribute to an HSA, you can also contribute to a limited-purpose
Healthcare FSA, if you want. However, the IRS limits the use of your FSA
to dental and vision expenses only. You don’t need a limited-purpose
Healthcare FSA for these expenses, because the HSA can cover
these costs. But some people see an advantage in having both types
of accounts to help manage their expenses.
Money in Your HSA
If you have money left over in your HSA at the end of the year, the balance
rolls over to the next year to help pay for your future healthcare needs.
The HSA rollover is not limited — all remaining HSA dollars roll over to the
next plan year — even if you enroll in the PPO option in the upcoming year,
retire or terminate employment. The account is yours.
If you terminate employment mid-year and elect to continue participating
in the HDHP under COBRA, you will have access to your full existing HSA
account balance. In addition, you can continue to make contributions. After
employment ends and if you elected to have a payroll deduction for your
HSA, your deposits will be initially made on an after-tax basis but can be
itemized on your tax return.
Note: If you are married and pass away with an account balance, your
surviving spouse/domestic partner has access to your account but cannot
make any additional contributions to it.
Medical (Including
Prescription Drug)
Prescription Drugs
Prescription drugs are covered just like any other medical expense under
the CDHP and the HDHP. When purchasing prescriptions at a retail
pharmacy, simply present your medical ID card first and then pay for your
prescription with your Healthcare Spending Card (HCSC), if you have HRA
dollars available, or your HSA debit card if you have HSA funds available.
If no HRA or HSA dollars are available, you will be required to pay the full
cost of the prescription until you have fulfilled your Member Responsibility
(excluding any eligible FSA you elect to use).
A mail order program is also available for participants taking maintenance
medications. It is easy to buy prescription drugs through mail order. First,
have your physician write a prescription for a 90-day supply plus three
refills (if applicable). This will allow you to receive your medication for up
to a year before a new prescription is needed. The next step is to send
the prescription to UHC along with the Mail Order Form and Health,
Allergy and Medication Questionnaire. These documents can be found on
www.myuhc.com.
Currently using mail order?
If you are receiving mail order medications through your UnitedHealthcare
prescription drug plan and have an open refill as of December 31, 2012,
UnitedHealthcare pharmacy will receive this information so you will not
need to obtain a new prescription.
New ID Cards
If you are enrolling in the PPO benefit option and live in a state where the
PPO is administered by UnitedHealthcare, you will receive one ID card to
present to your medical and pharmacy providers. If Highmark will be the
medical plan administrator, you will receive a “pharmacy-only” ID card from
UnitedHealthcare in addition to your Highmark medical ID card.
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31
Medical (Including
Prescription Drug)
Using Network Providers
With the CDHP and HDHP medical benefit options, you have access to
the UHC national network of doctors, pharmacies, hospitals and other
professionals that provide services at competitive negotiated rates. You
also have the freedom to use providers who are not part of the network.
However, you will pay significantly higher out-of-pocket costs including
above and beyond the recommended reasonable and customary (R&C)
charges.
Present your ID card to your provider at each visit. Your provider will send a
claim to UHC for services rendered and UHC will either:
Pay
the provider from your HRA or traditional Healthcare FSA;
Send
an Explanation of Benefits (EOB) to the provider indicating what
the Plan paid and your Member Responsibility; the provider will then bill
you directly for this service;
Pay
80 percent of the claim (60 percent for out-of-network services)
and inform the provider you are responsible for the remaining 20 (or
40) percent. The provider will then bill you for the 20 (or 40) percent
balance directly; or
Pay
100 percent because the out-of-pocket maximum has been met.
You should not be asked to pay the provider at your visit, unless you use
out-of-network providers.
Important Note: Network providers are subject to change based on
participation agreements with the claims administrator; however, this is
not a qualified status change and you will not be allowed to change your
coverage election for this reason.
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Medical (Including
Prescription Drug)
Annual Out-of-Pocket Maximum
The annual out-of-pocket maximum is designed to limit the amount a
person pays for covered medical and prescription drug expenses in one
calendar year. Once that individual reaches the annual out-of-pocket
maximum, the medical benefit plan option pays 100 percent of covered
medical expenses including prescription drug expenses for the rest of
the calendar year.
Under the CDHP and HDHP medical benefit options, 100 percent of
covered medical and prescription drug expenses are paid for all covered
participants (combined) for the rest of the calendar year once the out‑of‑pocket
maximum is met by any combination of dependents — it is not an
individual maximum.
For your protection, there is a
limit each plan year as to how
much you need to pay out of your
own pocket — the out‑of‑pocket
maximum. When the amount
is reached, all of your eligible
expenses are covered up to
100 percent for the rest of
the year.
Important Note: If you use out-of-network providers, you will be
responsible for any charges above the allowable amount even if
the out-of-pocket maximum has been met.
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33
Medical (Including
Prescription Drug)
Example of Using the CDHP With an HRA
The following example shows how the CDHP with an HRA is used to pay medical and prescription drug
expenses over a two-year period.
Jim is a CenturyLink employee with employee and spouse coverage.
Claim $
Year 1
HRA
Balance
Explanation…
$1,500 HRA Company Contribution
Physical (Sally)
$500 Paid 100% as preventive.
Prescription Drugs (Jim)
Sick Doctor Visit (Jim)
$50 Paid 100% from HRA.
$450 Paid 100% from HRA.
Balance at the end of Year 1
(To be added to Year 2 HRA Contribution)
Year 2
$1,500 HRA Company Contribution
(Plus $1,000 rollover from Year 1)
Physical (Jim)
$500 Paid 100% as preventive.
Surgery (Sally)
Emergency Room (Jim)
$1,500
Remaining $2,750 is paid at 80% ($2,200); Jim pays
20% ($550) coinsurance but since there are HRA dollars
available, $250 is paid from HRA and Jim pays $300 out
of pocket.
$1,000 Paid at 80% ($800); Jim pays 20% ($200) coinsurance
and reaches the $3,000 out-of-pocket maximum.
CTL
Paid
$1,500
$1,500
$0
(-$50)
$1,450
$0
(-$450)
$1,000
$0
$1,500
(+$1,000)
$2,500
$500
$1,500
$2,500
$5,000
-$1,500 First $1,500 paid 100% from HRA.1
$3,500
-$750 Next $750 is paid 100% from the “Member
$2,750 Responsibility” portion of HRA.
-$2,200
$550
-$250
$300
Employee
Paid
$0
$500
$0
(-$1,500)
$1,000
(-$750)
$250
$0
$2,200
(-$250)
$0
$300
$0
$200
$800
$0
$0
$100
$500
$7,100
Out-of-Pocket Maximum = $3,000
HRA amount1 =
Member Responsibility =
Coinsurance =
$1,500
$750
$750
$3,000
(Jim used the $1,000 rollover from Year 1 to pay part of
his Member Responsibility and coinsurance in Year 2)
Prescription Drugs (Jim)
$100 Plan now pays 100%.
Total Paid
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1
Example assumes only network providers were used.
Medical (Including
Prescription Drug)
Virtual Network Feature
All medical benefit plan options offer a Virtual Network feature. If you live
outside the PPO, CDHP or HDHP network area or outside of the United
States, the Plan will still pay benefits for you and your enrolled dependents
at network levels. This “Virtual Network” is designed to help employees
who live in rural areas with no access to network providers. You may have
to pay the provider at the time of service and then submit a claim to the
Plan for reimbursement. After the required network deductible, coinsurance
and/or copayments, the Plan will pay 80 percent of most covered services —
you will be responsible for any remaining amount. Covered services will be
subject to reasonable and customary charges. You will automatically be
enrolled in this option once you select your medical option.
Your Confirmation Statement materials will confirm if you are eligible for a
“Virtual Network” option. Your UHC or Highmark ID card will also include an
“Out of Area” designation if you live in a virtual PPO/CDHP/HDHP area.
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35
Medical (Including
Prescription Drug)
Upcoming Transition to OptumRx
In mid-2013, UnitedHealthcare (UHC) is transitioning its prescription drug
benefit services to OptumRx, a UnitedHealth Group company. You can
expect a smooth transition and consistent service during this transition, as
well as access to a full range of prescription drug benefits and support.
What is changing?
You will experience changes with the following:
You
will receive a new UHC ID card with the OptumRx information
OptumRx
will be the new mail service pharmacy, and the OptumRx
call center will support mail service prescription drug inquiries
Visit
www.myuhc.com to explore a new prescription drug section.
What isn’t changing?
We anticipate no change to your benefit coverage as a result of the
transition to OptumRx. You can expect prescription drug service and
support comparable to what you have today.
When will the transition occur?
CenturyLink’s prescription drug plans will transition in mid-2013. You will
remain with UHC/Medco until the transition to OptumRX in mid-2013.
How will I be notified?
You will be notified by mail about 35 days prior to your targeted transition
date. Included in the notification letter will be a list of Frequently Asked
Questions about the transition. You will receive a new ID card about 10 to
20 days prior to the scheduled transition date.
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Medical (Including
Prescription Drug)
Using the UHC Prescription Drug Program —
with the PPO Option ONLY
Under the UHC program, you either pay a flat copay amount or a
coinsurance amount, depending on the type of drug you purchase and
where you purchase the drug.
For prescriptions purchased at a non-participating pharmacy, you will have
to pay the entire cost up front (without the network discount) and submit a
claim for reimbursement. You will be reimbursed at a lower rate, based on
the lesser of the reasonable and customary rate and the pharmacy price for
that drug, minus your out-of-network coinsurance or copayment and any
other applicable charges. So, as you can see, you save money when you
use network pharmacies.
Important Note About Difference in Costs: If you or your doctor requests
the use of a brand name drug when a generic drug is available, you will pay
the difference between the cost of the brand name drug and its generic
equivalent, in addition to the coinsurance or minimum/maximum amount for
the brand name drug. For example, if a generic medication is available and
the total cost is $100, and you choose to purchase a brand name formulary
drug with a cost of $300, you pay the 30 percent coinsurance (minimum
$35; maximum $60) PLUS the $200 difference in cost between the generic
and brand name drug. By law, both brand name and generic drugs must
meet the same standards for safety, purity, strength and quality (so they are
chemically equivalent). There may be times when a brand is considered the
lower-cost alternative to the generic. During these times, you will not pay
the cost difference.
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37
Medical (Including
Prescription Drug)
Quick Glance — UHC Prescription Drug — PPO
Retail Pharmacy (up to a 30-day supply)
Tier 1
$10 copay
Tier 2
You pay 30% coinsurance with...

$35 minimum

$60 maximum
Tier 3

$50 minimum

$100 maximum
Retail Pharmacy (maintenance drugs ONLY — cost after 2 fills at pharmacy)
Tier 1
$30 copay
Tier 2

$65 minimum

$90 maximum
Tier 3

$140 minimum

$175 maximum
Mail Order (up to a 90-day supply)
Tier 1
$25 copay
Tier 2
$80 copay
Tier 3
$140 copay
Specialty Mail Order Medication (up to a 30-day supply)
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Tier 1
$15 copay
Tier 2
$65 copay
Tier 3
$125 copay
Drug Coverage
UHC Prescription Drug List (PDL)
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Medical (Including
Prescription Drug)
Certain Medications Not Covered
(The list below is not all inclusive and is subject to change)
Some drugs and medications are not covered under the prescription drug
program, such as:
allergy
shots (which may be covered under the medical benefit options);
drugs
for cosmetic purposes only;
drugs
not approved by the Food & Drug Administration (FDA);
drugs
with no FDA-approved indication for treatment of a
particular condition;
experimental
or investigative drugs;
infertility
drugs (which may be covered under the medical
benefit options);
over-the-counter
vitamins,
Prescription drug
coverage provides...

$0
copay for diabetic supplies
(syringes, needles and strips) —
retail and mail order

60,000
network pharmacies

Smoking
cessation prescription
medication available if enrolled
in the UHC QuitPower or
Highmark Blue Cross Blue
Shield Telephonic Smokeless®
programs.
(OTC) drugs; and
minerals and food supplements (except prenatal vitamins).
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39
Medical (Including
Prescription Drug)
Medical Identification (ID) Cards
New ID cards will be mailed to you from the Claims Administrators at the
end of December. If you are enrolled in a UnitedHealthcare Medical benefit
plan option, you will receive one ID card to present at both your medical
and pharmacy providers. If you are enrolled in a Highmark option, you will
receive two ID cards: a medical card from Highmark and a pharmacy card
from UnitedHealthcare.
Check to make sure that all information on your ID cards is correct. If there
are errors, please contact the CenturyLink Service Center immediately.
If you need to obtain healthcare services prior to receiving your ID
card, visit the website for the administrator of the coverage you elected
or contact the CenturyLink Service Center at (800) 729-7526. Many
administrators offer participants the opportunity to register and login to
print temporary ID cards, view eligibility, check claims status and more. You
may enroll as a participant on the website once the Claims Administrator
has received your eligibility and updated its system (late December if you
made a plan change).
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Medical (Including
Prescription Drug)
Preventive Care
Preventive care as outlined by the Patient Protection and Affordable Care
Act (PPACA), also known as Health Care Reform, is paid at 100 percent
with no deductible or copay required — if you use network providers. This
generally includes:
Preventive
service “A” and “B” recommendations of the U.S. Preventive
Services Task Force (USPSTF). This list will be updated on an
ongoing basis, and the complete and current list can be found at:
http://www.healthcare.gov/law/resources/regulations/prevention/
recommendations.html
Healthcare Advocacy
Services
Have an issue with a healthcare
claim? Need help accessing
healthcare services? See page 43
for assistance with your questions.
Certain
preventive medications as defined under guidelines prepared
under the PPACA
Preventive care generally does not include any service or benefit intended
to treat an existing illness, injury or condition. Services that do not meet the
Health Care Reform preventive care guidelines outlined under the PPACA
will not be covered at 100%.
Preventive Care for Women
For 2013, here is a list of added network services that the plan will cover
at 100 percent, according to newly enacted Health Care Reform guidelines
that enhance preventive care for women:
Preconception
and prenatal care
Gestational
diabetes screening — for women 24 to 28 weeks pregnant
(or anytime, if at high risk)
Contraception
and contraceptive counseling — including many FDAapproved Tier 1 contraceptive prescriptions, methods and sterilization
procedures. Tier 1 contraceptives on the UHC Advantage Prescription
Drug List (PDL) will be available without cost-share.
Breastfeeding
support, supplies (including breastfeeding equipment) and
counseling — while pregnant and postpartum
Human
papilloma virus (HPV) DNA testing — for women 30 and older
Annual
STI counseling and HIV screening and counseling for women
Interpersonal
and domestic violence screening and counseling.
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Medical (Including
Prescription Drug)
New On-line Resources Available
from UnitedHealthcare
UnitedHealthcare Health4Me provides instant access to critical health
information for you and your dependents — anytime/anywhere. Whether
you want to find a physician near you, check the status of a claim or speak
directly with a healthcare professional, Health4Me is your confidential go-to
resource. Key features include:
Search
Store
View
for physicians or facilities by location or specialty
your favorite physicians and facilities
claims
Have
an Easy Connect Representative contact you to answer
any questions
View
and share medical plan ID card information
Locate
urgent care facilities and Emergency Rooms
Check
status of deductible and out-of-pocket spending
UHC.TV is a new online television network that presents relevant, focused,
educational and entertaining video programs about good health and living
well to help people get inspired to grow healthy and live better. Simply type
UHC.TV into your Internet browser to start watching.
MyHealthcare Cost Estimator is a personalized online tool that allows you
to make more informed healthcare decisions. myHealthcare Cost Estimator
helps you estimate the cost of your healthcare based on your plan. When
you are able to get information based on your individual plan, you’ll have
the knowledge to better understand your choices and be in greater control
of your healthcare. Visit www.myuhc.com to access myHealthcare
Cost Estimator.
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Healthcare Advocacy
Services
Healthcare Advocacy Services
All U.S. based CenturyLink employees eligible for healthcare benefits
have access to free Advocacy Services that can help address issues with
claims and accessing healthcare services. If you have an issue with your
health and life benefits that you have been unable to resolve on your
own or through the Claims Administrator or your healthcare provider, you
can contact an Advocate to assist you with your questions. Advocates are
available to help you:
Understand
and access all your available benefits — medical,
prescription drug, dental, vision, life insurance and mental health,
as applicable
Resolve
Explain
your healthcare billing and insurance claim disputes
your benefits paperwork
Obtain
medication or treatment
Locate
doctors and hospitals
Explain
Medicare guidelines
Answer
any questions you have about company-provided health and
life benefits
You can reach an Advocate by calling the CenturyLink Service Center at
(800) 729-7526. Select the applicable medical, dental or life benefits option.
Advocacy hours are M–F, 8:30 a.m. to 6 p.m., Central time.
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43
Working Spouse/
Domestic Partner Surcharge
Working Spouse/Domestic Partner Surcharge
It’s important that CenturyLink keeps healthcare plan costs as low as
possible for all of us. If your spouse/domestic partner has coverage
available through his/her employer and doesn’t enroll, it shifts the cost from
his or her employer’s plans to CenturyLink and CenturyLink employees.
As a result, a working spouse/domestic partner surcharge of $50 per pay
period is added to your medical premium when all of the following apply:
1. I am married or in a domestic partner relationship
2. My spouse/domestic partner is currently employed
3. My spouse/domestic partner is not employed by CenturyLink
4. My spouse/domestic partner is eligible for but has not elected to enroll
in his or her employer group medical plan
5. My spouse/domestic partner is eligible for coverage under his or her
employer group medical plan
6. I will enroll my spouse/domestic partner in the CenturyLink group
medical benefit option.
If you answered “Yes” to all the statements above, the surcharge applies to
you and you must select “Yes” in response to the working spouse/domestic
partner question when you enroll on the CenturyLink Health and Life
Benefits website at www.centurylinkhealthandlife.com.
If you answered “No” to at least one of the statements, the surcharge
doesn’t apply to you and you will select “No” in response to the working
spouse/domestic partner question when you enroll on the CenturyLink
Health and Life Benefits website.
If you selected the “No” response to the Working Spouse/Domestic Partner
Surcharge question because your spouse/domestic partner’s annual
enrollment has passed or your spouse/domestic partner does not work,
it is your responsibility to notify the CenturyLink Service Center when your
spouse/domestic partner becomes eligible and doesn’t elect to enroll in
his or her employer’s group medical plan. If your spouse/domestic partner
enrolls in his or her employer’s group medical plan (when eligible) and
remains on the CenturyLink Health Care Plan (secondary), no notification
is required.
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Working Spouse/
Domestic Partner Surcharge
If the enrollment period has passed for a spouse/domestic partner who
could have enrolled in his or her employer’s medical plan and did not, and
if his or her employer does not recognize your benefits Annual Enrollment
period as a qualifying event for your spouse/domestic partner to enroll,
you may elect to cover your spouse/domestic partner for a period of time
under the CenturyLink’s Plan without paying the working spouse/domestic
partner surcharge.
The surcharge will be suspended until your spouse/domestic partner has
the opportunity to enroll for coverage with his or her employer. Important
Note: Once your spouse/domestic partner has the opportunity to sign
up for his or her employer’s coverage, it is your responsibility to notify
the CenturyLink Service Center at (800) 729-7526 within 45 days of your
spouse’s/domestic partner’s enrollment period, to either:
Remove
your spouse/domestic partner from coverage under the
CenturyLink Health Care Plan; or
Keep
your spouse/domestic partner covered under the CenturyLink
Health Care Plan and begin paying the working spouse/domestic partner
surcharge because, your spouse/domestic partner chose not to enroll in
his/her employer’s medical plan.
Note: the working spouse/domestic partner surcharge does not apply to
dental or vision coverage.
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45
Tobacco-Free Discount
You and your covered dependents
enrolled in your medical benefit plan
option must all be tobacco‑free
or enrolled in a tobacco cessation
program to receive the 7.5 percent
tobacco‑free discount.
Tobacco-Free Discount
The Company offers a 7.5 percent tobacco-free discount on the cost of
your medical premium deductions. You will be asked to provide information
on whether or not anyone enrolled in the medical benefit option is a
smoker or tobacco user and if all smokers/tobacco users are enrolled in a
Company-recognized tobacco cessation program at the time you complete
your enrollment. The tobacco-free discount is only available if all your
dependents covered under your medical benefit option are tobacco‑free
or enrolled in a tobacco cessation program. You must be enrolled in a
CenturyLink medical benefit plan option to be eligible for the discount.
These rates will remain in effect for the entire plan year. As a result, no
change will be allowed during the plan year since changing smoking/
tobacco use status mid-year is not a Qualified Life Event.
About Company-recognized Tobacco
Cessation Programs
Company-recognized tobacco cessation programs vary based upon
available resources in your area. You can find information on programs
through the following resources:
Your
CenturyLink wellness program, currently administered by the
medical claims administrators
The
American Lung Association — this organization offers a free online
smoking cessation program called “Freedom From Smoking” in addition
to links on their website, including an Action Plan and resources that can
be ordered; just visit http://www.lungusa.org
The
Quit For Life program, brought to you by The American Cancer
Society and Alere Wellbeing, Inc., helps you tailor a quit plan with a
Quit Coach while offering free 8 weeks Nicotine Replacement Therapy
and telephonic coaching calls. For more information please call
(866) 784-8454 or www.quitnow.net/centurylink. Registration and
Quit Coaches are available 24 hours, 7 days a week.
You are responsible for any costs associated with a smoking cessation
program or for any items that may help you or a family member to stop
using tobacco products.
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Dental
CenturyLink offers two dental benefit plan options, administered by
MetLife, to help keep you smiling:
Basic
option
Enhanced
option
You may also waive dental coverage. There is no rebate credit offered if you
elect to waive dental coverage.
How It Works
The Basic option is a traditional, fee-for-service plan option that covers
preventive as well as comprehensive dental work. You pay an annual
deductible before the option pays benefits, except for diagnostic and
preventive care, which is covered at 100 percent with no deductible.
There is a “passive” preferred provider organization (PPO) feature, which
means you get additional discounts when you use MetLife Network
providers for dental services.
The Enhanced option is a preferred provider organization (PPO) with
higher-level coverage. It pays benefits for all the same services as the
Basic option, and also includes orthodontia. Using the MetLife PPO
Network gives you the most savings possible. You are not required to
use a network dentist; however, your out-of-pocket costs will be higher
if you go out-of-network. You will be responsible for any charges above
the reasonable and customary (R&C) amounts.
Finding a Network Dentist
To find a PPO dental provider in your area, use the Find a Doctor tool on the
CenturyLink Health and Life website www.centurylinkhealthandlife.com.
Remember to identify your MetLife Network when talking with providers —
ask if they are a MetLife PPO provider. Many dentists will say they accept
MetLife, but that doesn’t always mean they are a network provider.
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47
Dental
Maximum Allowable Amount
Dental benefits are based on MetLife’s maximum payment allowance. MetLife’s maximum allowed
payment is determined by the lesser of the participating dentist’s submitted fee or the MetLife
participating dentist maximum fee as set by provider contracts. Participating dentists base
fees on pre-negotiated contracts with the network. Non-participating dentists’ reimbursement is
based, in part, on the average fee submitted by participating dentists and benefits are limited based
on what MetLife determines to be Reasonable and Customary charges.
If you use a dentist participating in the PPO or Premier Network, you will not be billed for the
remaining balance over the maximum allowable amount.
Coordinating Dental Claims
Both CenturyLink dental options coordinate benefits with other dental plans to cover you and your
enrolled dependents. That means your CenturyLink dental coverage and other group dental plans
work together to pay covered expenses.
If the CenturyLink Dental Plan is primary (the first to pay), benefits will be paid as if no other dental
plan exists.
If the CenturyLink Plan is secondary (the second to pay), the Plan will pay benefits after the primary
plan pays if there is a balance. Standard Coordination of Benefits is a cooperative claim payment
between two or more insurance carriers that applies when a participant is covered under more than
one plan. Reimbursement between the carriers can result in a 100 percent reimbursement of benefit.
However, the participant will not realize payment above the 100 percent reimbursement.
Example of Coordinating Benefits
Assuming the annual deductible has been met and the CenturyLink Dental Plan pays 80 percent,
here’s how benefits would be calculated if CenturyLink were coordinating benefits with another plan
that is primary. In this example, “The Plan” refers to CenturyLink.
Step 1: Calculate primary payment
Allowable Fee (PDP Fee/Reasonable
& Customary Amount)..........................$1,000
The Plan would have paid.....................x 80%
..............................................................$800
Step 2: If other insurance paid less
Step 2: If other insurance paid more
Other insurance paid..............................$600
The Plan would pay............................... $400
The Plan would pay............................... $100
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Step 2: If other insurance paid the same
The Plan would pay................................$200
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Dental
Quick Glance — Dental Plan Benefit Option
Basic Option
Enhanced Option
Passive PPO Network
PPO Network
Annual Benefit
Maximum
$1,000/person
(does not include oral
surgery)
$2,000/person
(does not include oral surgery
or orthodontia)
Annual Deductible
$25/person for General
Care and Major and
Restorative; no deductible
for Diagnostic, Preventive
or Oral Surgery
$50/person for General Care and Major
and Restorative
(does not include Orthodontia); no
deductible for Diagnostic, Preventive
or Oral Surgery
Diagnostic and
Preventive (cleanings,
exams & X-rays)
Plan pays 100%
up to maximum
allowable amount
Plan pays 100% up
to reasonable and
customary (R&C);
two visits per year
Plan pays 100% up
to reasonable and
customary (R&C);
two visits per year
General Care (fillings,
root canals and
periodontics)
Plan pays 50%
up to maximum
allowable amount
Plan pays 80%
up to maximum
allowable amount
Plan pays 60% up
to reasonable and
customary (R&C)
Major and Restorative
(crowns, dentures and
bridges)
Plan pays 50% up to
maximum allowable
amount
Plan pays 50% up
to R&C amount
Plan pays 50% up
to R&C amount
Oral Surgery
80%, no deductible
or limit
80%, no deductible or limit
Orthodontia
(Adult and child(ren))
Not covered
Plan pays 50% up
to R&C after $50
lifetime orthodontia
deductible
(separate
from annual
deductible)
Orthodontia Lifetime
Benefit Maximum
N/A
$1,500
(separate from annual individual
benefit maximum)
Administrator
MetLife
Out-of-Network
Plan pays 50% up
to R&C after $50
lifetime orthodontia
deductible
(separate
from annual
deductible)
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49
Vision Care
To search for a network vision care
provider in your area, use the Find a
Doctor tool on the CenturyLink Health
and Life Benefits website www.
centurylinkhealthandlife.com.
CenturyLink can help you and your dependents save money on
vision exams, eyeglasses, contact lenses and laser eye surgery
when you receive services from doctors in the Vision Service Plan
(VSP) Network.
How It Works
When you or a covered dependent needs vision care services, you pay a
copay for eye exams and materials for each covered person. If you need
contacts instead of glasses, VSP provides an allowance toward the cost.
Discounted fees also are available for laser eye surgery.
The Plan pays the highest level of benefits when you choose providers in
the VSP Network.
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Vision Care
Quick Glance — Vision Care Plan
Service
VSP Doctor
Open Access Provider
Eye Exams (once every
plan year)
Plan pays 100% after $20 copayment
VSP reimburses you (after $20 copayment) up to a
maximum of $45
Pays 100% after $40 copayment1
VSP reimburses you (after $40 copayment) up to:
Lenses:
Single Vision
$45
Lined Bifocals
Lined Trifocals
Lenticular
(one every plan year)
$65
$85
$125
(Does not include polycarbonate lenses for child(ren))
(Includes polycarbonate lenses for child(ren)
under the age of 19)
Lens Options
Member pricing on any non-covered lens
options (i.e., progressive lenses, high-index
lenses, etc.)
No discounts available
Frames (one pair every
other plan year)
Plan pays 100% of VSP allowable amount of
$130 after $40 copayment;1 you will receive
a 20% discount on the charges over the VSP
allowable amount
VSP reimburses you (after $40 copayment) up to a
maximum of $47
Contacts (contact
lenses may be chosen
once every plan year
instead of eyeglass
frames and lenses)
Plan pays 100% for routine eye exam after $20
copayment plus up to $125 for contact lens
exam (fitting and evaluation) and contacts; a
15% discount will be applied to the contact
lens fitting and evaluation before the $125
allowance is applied.
VSP reimburses you up to $105 for contact lens exam
(fitting and evaluation) and contacts
Laser Eye Surgery2
Discounted rates available. The VSP doctor will
coordinate referrals for qualified candidates to
participating VSP Laser Surgery Centers. The
maximum you will pay is:
PRK: up to $1,500 per eye
LASIK: up to $1,800 per eye
Custom LASIK: up to $2,300 per eye
(using wavefront technology only — other
technologies not covered under Custom LASIK)
No discounts available
Administrator
Vision Service Plan (VSP)
1 The
$40 material copayment is charged only once when lenses and frames are purchased
at the same visit.
2 Your
pre- and post-operative services and laser correction are provided at a discounted
rate at participating laser centers. While discounts will vary by location, the average is
15 percent off of the laser center’s Usual & Customary price. Additionally, if the laser center
is offering a temporary price reduction, you may receive an additional discount. Please consult
your VSP doctor for further details.
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51
Flexible Spending
Accounts
Coverage of
Over-the-Counter Drugs
Certain types of over-the-counter
(OTC) medications are eligible for
reimbursement, including antacids,
allergy medicines, pain relievers
and cold medicines BUT only with
a prescription. Some OTC drugs
are considered “dual-purpose,”
meaning that they may be used
for personal/cosmetic or general
health as well as a medical
purpose. Dual-purpose drugs may
be reimbursed with supporting
documentation stating medical
necessity and a doctor’s written
prescription. Medications that are
used for your general health, such
as dietary supplements, vitamins
(except prenatal), toiletries and
sundry items, are not eligible for
reimbursement.
Note: The Healthcare Spending
Card cannot be used to purchase
over-the‑counter medications that
require a prescription. You will need
to pay for the medication out of
your pocket and submit a claim to
your FSA. Your claim must include
the prescription for the medication
(exception for insulin and OTC
supplies, such as bandages,
crutches, etc.).
You and your dependents can save money by setting aside before-tax
dollars in a Flexible Spending Account (FSA). CenturyLink offers two types
of FSAs: Healthcare and Dependent Day Care. Both Flexible Spending
Accounts are administered by UHC.
Healthcare FSA
As a CenturyLink employee, you can contribute to a Healthcare FSA
through automatic payroll deductions on your before-tax earnings. Under
federal tax rules:
You
can use an FSA to manage qualified out-of-pocket healthcare
expenses for you and your covered dependents who meet federal
eligibility rules for tax purposes. See sidebar on page 53 for details.
New
for 2013: Two Healthcare FSAs — a Traditional Healthcare FSA
and a Limited Healthcare FSA. If you select the HDHP medical benefit
option with the HSA, you can still enroll in a Healthcare FSA, but it will
be a Limited FSA. Funds in the Limited FSA can only be used for dental
and vision expenses. Both Healthcare FSAs can be used for eligible
expenses incurred from January 1, 2013 to March 15, 2014.
—— Traditional: This FSA can be used to pay out-of-pocket costs you
incur for the full range of eligible medical, dental, vision and other
healthcare expenses you and your dependents have during 2013.
However, based on new IRS regulations under the Health Care
Reform Act, the amount an individual can contribute during the year
is lower than in the past.
—— Limited: This FSA is for those employees who elect to participate
in the HDHP medical benefit option and choose to participate in the
new Health Savings Account (HSA). According to IRS rules, if you
have an HSA to help you pay out-of-pocket expenses not covered
under the medical benefit option, you can use an FSA to cover only
healthcare expenses that are not part of the medical benefit option.
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For 2013, you can contribute from $150 to $2,500 per year before‑tax.
And, if your spouse has an FSA with another employer, you both can
set aside the full amount that each of your employers allow — up to
this new limit.
For 2013, this FSA also allows you to contribute from $150 to $2,500
per year before tax, but your use of this money is limited to dental,
vision and other costs of care that are not covered under the medical
benefit option.
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Flexible Spending
Accounts
Dependent Day Care Account
The IRS did not change limits for Dependent Day Care FSAs; you can
contribute from $150 to $5,000 per year before-tax. You may use your
2013 Dependent Day Care FSA for reimbursement of expenses incurred
from January 1, 2013 to March 15, 2014. If you participate in this FSA and
during the year go out on leave with pay and later return from leave, you
need to contact the CenturyLink Service Center to make a positive election
and “re-elect” a new Dependent Day Care FSA amount. If you enroll midyear, contributions will be prorated over the remaining pay periods in the
calendar year from your benefit eligibility date.
Domestic Partners
Ineligible for FSA
The IRS does not recognize
domestic partners and domestic
partners’ dependent children;
therefore, expenses incurred for
domestic partners’ children are
not eligible for reimbursement
through your FSA.
If you are married and file separate federal income tax returns, the maximum
that you can contribute to the Dependent Day Care FSA is $2,500. If you
are considered a highly compensated employee (defined by the IRS as
making more than $115,000 in 2012), the maximum you can set aside
in the Dependent Day Care FSA is $2,000. This amount is subject to
change as determined by the Plan Administrator.
Eligible Dependents
The Healthcare Account reimburses qualified expenses incurred by you
and/or an eligible dependent, such as your spouse or any other person
who would qualify as a dependent under federal income tax rules.
The Dependent Day Care Account reimburses qualified daycare expenses for:
your
dependent child under age 13;
your
physically or mentally disabled spouse; or
any
other person who qualifies as your dependent for federal income tax
purposes — including a handicapped child of any age or a dependent
parent who is physically or mentally incapable of self-care.
Use the Dependent Day Care Account for reimbursing expenses
associated with daycare for a dependent while you (and your spouse) work.
For a full list of “eligible expenses” for “eligible dependents,” review the
SPD or contact UHC at (877) 311-7849 or visit www.myuhc.com.
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Flexible Spending
Accounts
Plan carefully! You will forfeit any
funds in your FSA accounts not used
to reimburse expenses incurred
during the allowed time period.
No Matter What,
Save Your Receipts!
While many transactions can
be approved without requesting
receipts, some may require you
to send in additional information to
document the claim. If required,
UHC will send you a substantiation
request. We recommend that you
retain all receipts for all debit
card purchases at least until the
end of the following plan year.
Retaining substantiation is an IRS
requirement. In addition to the
Healthcare Spending Card, you also
may choose to file a paper claim for
reimbursement.
Tip: At the beginning of the year,
start putting your healthcare receipts
in an envelope marked “2013
Healthcare Receipts.” When you
need to substantiate a claim, you’ll
know where to find the receipts.
Important: Expenses eligible under
both the HRA and Healthcare FSA
will be paid from the HRA first if you
have a balance left in your account.
Planning Your FSA Contribution Amount
Plan your contributions carefully. The amount you elect to contribute to an
FSA can be used only for eligible expenses that you incur from January 1,
2013 to March 15, 2014 as an active participant in the medical plan. Except
in limited circumstances, you will not be allowed to increase or decrease
the amount you deposit during the year (see paragraph below). You also
forfeit the money in your FSA if it is not used to reimburse eligible expenses
incurred within the dates of service mentioned above. In other words, you
cannot get money back at the end of the year if you have not spent it on
eligible expenses as established by the IRS.
Note: FSA contributions will be prorated over the remaining pay periods in
the calendar year from the date of eligibility.
You Forfeit Unused FSA Balances
You may submit a reimbursement request to UnitedHealthcare (UHC) no
later than April 30, 2014 for any claims incurred between January 1, 2013
and March 15, 2014. Reimbursement requests received after April 30, 2014
that do not have a U.S. Postal Service postmark date on or before April 30,
2014 will not be considered for processing. Claims sent by fax must be
received by UHC by close of business April 30, 2014.
Remember, after that period ends, any unused amounts are forfeited —
so it is important to estimate your expenses carefully when determining
your annual election.
Debit Card Feature
The FSAs have a convenient debit card, called Healthcare Spending Card
(HCSC), that can be used for certain IRS-qualified healthcare expenses.
Your Healthcare Spending Card will have your annual HealthCare FSA
election “stored” on the card. New enrollees will receive a Healthcare
Spending Card. If you are already enrolled in a UHC FSA in 2012, you will
not receive a new card for 2013, and therefore should keep your existing
card. Your 2013 FSA elections will be loaded and stored onto your
existing card. Dependent Day Care FSA money is loaded to the HCSC
on a contribution basis (as dollars are deducted from your paycheck).
Contribution files are sent to the Plan Administrator after the completion
of each pay cycle. Therefore, you may experience a delay in having your
Dependent Day Care FSA loaded to your HCSC.
If you are enrolling in the FSA for the first time, you must enroll by
November 21, 2012 in order to receive your Healthcare Spending Card
by January 1, 2013.
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Flexible Spending
Accounts
When you have a qualified expense — for example, a prescription drug
copay — you may pay for the expense using your Healthcare Spending
Card. This eliminates most paper claim filings and, more importantly, saves
you time and money by not requiring you to pay from your pocket and then
wait for reimbursement after completing a separate claim form.
Note: If you are participating in a Limited Healthcare FSA, you will not
receive a Healthcare Spending Card.
Eligible Dependent Day Care Expenses
Dependent day care expenses are eligible for reimbursement only if your
dependent lives in your home and the expenses permit you (if single) or you
and your spouse (if married) to work full-time or part-time or attend school
full-time. Employment may consist of service either within or outside the
home (including self-employment).
According to federal law, eligible dependent day care expenses include (but
are not limited to) the cost of:
For questions about eligible
healthcare and dependent
day care expenses, call
UnitedHealthcare at
(877) 311-7849 or refer to the
CenturyLink Flexible Spending
Account Summary Plan Description
on the Legacy CenturyLink
Intranet or the CenturyLink Health
com. You can also refer to
IRS Publication 502-Medical
and Dental Expenses and IRS
Publication 503-Child and
Dependent Day Care Expenses
found on www.irs.gov.
a
qualified child daycare center;
Important…
a
babysitter while you are working;
a
nursery school;
a
preschool;
a
day camp;
To participate in the Healthcare
or Dependent Day Care FSAs for
2013, you must make an active
election. Your 2012 election will
not carry over to 2013.
either
in-home or adult daycare for an incapacitated spouse or
dependent parent, excluding nursing home charges;
before-
or after-school care for dependents under age 13; or
The
cost of a kindergarten which is inseparable from the cost
of daycare.
Important Note: If you have concerns about whether your dependent or
your daycare or medical expenses are “eligible,” call UHC.
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Flexible Spending
Accounts
What Is Not Eligible
Expenses not eligible for reimbursement through your Dependent Day Care
FSA include (but are not limited to):
activity
child
fees;
care for when you are not working (expenses not work related);
education
expenses (except where kindergarten expenses cannot be
separated from the cost of daycare);
finder
and placement fees for daycare providers;
healthcare
expenses;
insurance;
late
fees;
meals
not included in tuition;
membership
fees;
miscellaneous
overnight
pre-paid
supplies;
camps;
daycare expenses;
registration,
enrollment, application or deposit fees;
transportation.
Note: You cannot be reimbursed for expenses for child care provided by
your dependents. For example, if you pay your teenage son or daughter to
care for another child of yours, you cannot use the Dependent Day Care
Flexible Spending Account to pay for that expense.
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Quick Glance –
Flexible Spending Accounts
Quick Glance — Flexible Spending Accounts
Healthcare
Dependent Day Care
How FSAs Work
When you put money into an FSA to pay out-of-pocket eligible healthcare or dependent day care expenses,
you save money on taxes. That is because the money you use to fund an account comes out of your paycheck
before federal income and Social Security taxes are deducted. The result? You pay less in taxes and have more
take-home pay.
Eligible Expenses
Traditional FSA
Eligible out-of-pocket healthcare expenses that are
not covered by a medical, prescription drug, dental or
vision care plan, including deductibles, copayments,
coinsurance and over-the-counter medications (with
a prescription).
Limited FSA
Eligible out-of-pocket dental and vision care
expenses that are not covered by the plans, including
deductibles, copayments, coinsurance (excludes
Medicare). Note: You will not receive an HCSC when
enrolled in the Limited FSA.
For additional details about eligible and
ineligible expenses, refer to the CenturyLink
FSA SPD on the Legacy CenturyLink Intranet or
the CenturyLink Health and Life Benefits website
www.centurylinkhealthandlife.com or contact
UHC directly.
Eligible out-of-pocket daycare expenses for the
care of child(ren) under age 13, an incapacitated
spouse or dependent parent so you (and your
spouse, if you are married) can work or attend school
full-time. For additional details about eligible and
ineligible expenses, refer to the CenturyLink
FSA SPD on the Legacy CenturyLink Intranet
or the CenturyLink Health and Life Benefits website
www.centurylinkhealthandlife.com
You Can Contribute
$150 to $2,500 a year to either the Traditional
Healthcare FSA or the Limited Healthcare FSA
$150 to $5,000 a year
per family
Making Mid-Year Changes
Limited changes allowed with qualified status change
Minimum Claim/
Reimbursement Amount
$25
Direct Payment of Services
Healthcare Spending Card from UHC (a convenient MasterCard debit card that has your balance elections
“stored” on the card so you can use it to pay qualified expenses, eliminating the need for filing most claims for
reimbursement)
Reimbursement of
Out-of-Pocket Expenses
Most healthcare (medical, prescription, dental and vision) claims are submitted automatically to
UnitedHealthcare; however paper claim forms for Healthcare or Dependent Day Care can be mailed or faxed to
the address or fax number on the form. You have until April 30, 2014 to submit FSA claims incurred between
January 1, 2013 and March 15, 2014.
Administrator
UnitedHealthcare
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Flexible Spending Accounts
Need more information?
Obtaining Reimbursement
Contact the CenturyLink
Service Center at
(800) 729-7526
8:30 a.m. to 6:30 p.m.
Central time, M–F.
If
There are several ways to submit an eligible expense and receive
reimbursement under the FSAs:
you are enrolled in the CenturyLink medical/prescription, dental or
vision plans, your claims will automatically be submitted to your FSA
via an electronic file feed. If you don’t want your claims to automatically
roll to your FSA, you can turn this feature off on UHC’s website once
you are an enrolled participant. Refer to www.myUHC.com to make a
change.
Use
your Healthcare Spending Card to pay for qualified healthcare
expenses.
Submit
a paper claim by mail or fax (address and fax number are
shown on the FSA claim form). Claim forms can be found on the
CenturyLink intranet.
You
also have the option to set up direct deposit and have your FSA
reimbursement deposited directly into your bank account. Direct deposit
can be set up on the UHC website (after January 1 if you are a new UHC
participant). Go to www.myuhc.com to set up direct deposits.
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Understanding the
Healthcare Accounts
A health reimbursement account (HRA), the new health savings account (HSA) and the Healthcare
Flexible Spending Account (FSA) are not the same. Here’s how they differ...
NEW HSA Health Savings
Account (Works with the
High Deductible Health
Plan — HDHP)
HRA Health Reimbursement
Account (Works with the
Consumer Driven Health
Plan — CDHP)
FSA Flexible Spending Account
(Healthcare Account)
Who sets up the account?
You
CenturyLink
You
Who can contribute?
You
CenturyLink
You
Is account tied to
enrollment in a medical
benefit plan option?
Yes, the HDHP
Yes, the CDHP
No
Does the balance forward
each year?
Yes, and is portable after
termination or retirement
Yes, as long as you remained
enrolled in the Plan.
No, unused balance is forfeited
What can be reimbursed?
Qualified medical,
prescription, over‑the‑counter
drugs (with a prescription),
dental and vision care
expenses.
Qualified medical and
prescription expenses
Traditional: Qualified medical,
prescription and over‑the‑counter
drugs (with a prescription), dental
and vision care expenses.
Limited (for HDHP participants):
dental and vision expenses only
Is interest earned?
Yes, depending on
your balance
No
No
Can withdrawals be made?
Yes, subject to taxes and
early distribution penalty —
unless used for qualified
expenses
No
No
Is there a debit card?
Yes
Yes
Yes - Traditional FSA
No - Limited FSA
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Life and Accident
Life Benefit Differences...
The benefit amount of Companyprovided basic life insurance as
well as Basic AD&D and Business
Travel Accident is based on your
base salary plus target incentive.
This is referred to as “eligible pay.”
Supplemental life is based on your
base salary alone. Consider this
difference when calculating the
amount of coverage you need to
purchase.
Protecting your loved ones financially is important. That’s why
CenturyLink offers a full line of life and accident coverage for both
you and your dependent(s):
Basic
Life Insurance
Employee
Supplemental Life Insurance
Spouse/Domestic
Partner Supplemental Life Insurance
Child
Supplemental Life Insurance
Basic
Accidental Death & Dismemberment Insurance (AD&D)
Supplemental
Accidental Death & Dismemberment Insurance (AD&D)
Spouse/Domestic
Partner or Child Accidental Death & Dismemberment
Insurance (AD&D)
Business
Travel Accident
Note: If you are an active employee who elects an increase in your
Supplemental Life Insurance during Annual Enrollment that doesn’t require
Evidence of Insurability (EOI) (1x to 2x) and you are subsequently on leave
status on January 1, you are not eligible for the increase because you
must be an active employee on January 1, which is the date the newly
elected benefits would have commenced. Therefore, you will be placed
back to your “current” coverage, not your “requested” coverage. In this
situation, your increased coverage will take effect on the date you resume
active work.
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Life and Accident
Basic Life Insurance
Basic Life Insurance is provided to you automatically and at no cost.
Full-time employees receive basic life coverage equal to 1x eligible pay
(base pay + target incentive), rounded up to the nearest $1,000.
You pay taxes on the value of Employee Life Insurance coverage over
$50,000 — commonly called imputed income. This is added to your taxable
pay so that your beneficiaries will not pay taxes on benefits they receive
from this plan. Beneficiaries will have to pay taxes on interest that is
received from the death benefit.
If your base pay + target incentive exceeds $50,000, you can elect a flat
$50,000 in coverage to limit your imputed income. For those employees
who qualify, when you go online to enroll, you will see the flat $50,000 as
an option.
Important Note: If you are an active employee and you turn age 70, your
Basic Life Insurance coverage will reduce by 50 percent effective the first
day of the month following your 70th birthday.
Employee Supplemental (Supp) Life Insurance
You may purchase, with after-tax dollars, additional life insurance coverage
from 1x up to 8x base pay (rounded to the nearest $1,000). Benefit
amounts are based on base pay up to a maximum of $2,000,000.
Your supplemental life insurance coverage and costs will change as your
pay changes. Your cost will also change if you move to a new age bracket
following a birthday. The life insurance coverage and cost will take effect on
the first day of the month following your move to a new age bracket.
Important Note: If you are an active employee and you turn age 70, your
Employee Supplemental Life Insurance coverage will reduce by 50 percent
effective the first day of the month following your 70th birthday.
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Life and Accident
Special Enrollment
for Legacy Savvis
Employees
During 2013 Annual Enrollment you
will be able to elect Supplemental
Life coverage for yourself or
your spouse at a coverage level
equivalent to your existing Savvis
Supplemental Life coverage
without needing to complete
EOI. The enrollment system may
show that EOI is required, but if
your 2013 election is equivalent
to your current Savvis coverage,
your election will be approved
without EOI.
If you don’t currently have
Supplemental Life coverage,
you have a one-time opportunity
during 2013 Annual Enrollment to
do the following:

You
can elect employee coverage
of two times your earnings
without EOI approval.

You
can elect spouse/domestic
partner coverage of up to
$50,000 without EOI approval.
Quick Glance — Supplemental Employee
Life Insurance Options
Covered Person
Coverage Options
Rules
Waive Coverage
Employee
1 x Base pay
2 x Base pay
3 x Base pay
4 x Base pay
5 x Base pay
6 x Base pay
7 x Base pay
8 x Base pay
Administrator
MetLife1
Evidence of Insurability (EOI) is required if:
You are not enrolled currently and elect any
coverage option;
You are currently enrolled and increase your
coverage more than one tier (for example,
increasing coverage from 1x to 3x base
pay); or
You increase your coverage above 2x eligible
pay regardless of what you select (for
example, increasing from 3x to 4x base pay
or 6x to 7x base pay.)
Maximum coverage amount is $2,000,000.
Note: If you elect an amount of coverage that requires Evidence of
Insurability (EOI), your current election and cost will remain in force until
your EOI form is submitted and approved. Coverage will go into effect
the first of the month following the date of approval from MetLife, but
no sooner than January 1, 2013. You must be actively at work when the
coverage takes effect. Otherwise, your coverage will not take effect until
you resume active work. You have the right to appeal adverse decisions
in accordance with the Plan provisions. If the form is not submitted by the
deadline provided to you, your request will not be considered, and you will
be required to request the change again. Approval or denial of coverage
is made solely by MetLife, not CenturyLink. EOI is not required when
increasing coverage from your current coverage option of 1x base pay
to 2x base pay.
1 Basic
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Supplemental and Dependent Life Insurance coverage is issued by MetLife, Metropolitan Life Insurance Company, 200 Park
Avenue, New York, New York 10166. Contact Series: 83500. The Booklet-Certificate contains all details, including policy exclusions,
limitations and restrictions that may apply.
Life and Accident
Employee and Spouse/Domestic Partner
Supplemental Life Insurance Rates
Per $1,000 of Coverage
Age
Annual Premium
<25
$0.600
25–29
$0.648
30–34
$0.804
35–39
$0.840
40–44
$0.888
45–49
$1.512
50–54
$2.424
55–59
$4.488
60–64
$7.056
65–69
$12.696
70-74
$22.572
75-79
$22.572
80+
$22.572
Sample Calculations
If you are age 44 and elect to purchase $50,000 in Supplemental Life
coverage, your per-paycheck premium cost would be $1.71.
(0.888 x 50 = $44.40 annually /26 pay periods = $1.71 per paycheck)
Keep in mind: Under the above example, once you turn 45, your
per‑paycheck cost will increase to $2.91.
($1.512 x 50 = $75.6 annually / 26 pay periods = $2.91 per paycheck)
Note: It’s important to keep your dependent information up-to-date. If
no date of birth is on file for a spouse/domestic partner, the employee’s age
will be used to calculate Supp Life rates for the spouse/domestic partner.
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Life and Accident
Special note for those
with Spouse/Domestic
Partner Supplemental
Life Insurance…
In order to ensure your insurance
premiums are accurate for Spouse/
Domestic Partner Supplemental
Life Insurance, you must contact
the CenturyLink Service Center to
ensure that your dependent’s name
and date of birth are on file.
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Dependent Life Insurance
Dependent Life Insurance provides a benefit to you in the event of death
of your dependent. This valuable benefit offers financial protection at
reasonable group premiums, which you pay through after-tax payroll
deductions.
Dual Coverage Option For Child Supplemental Life
Co-employed spouses who wish to have Supplemental Life coverage for
their children must select which employee will hold the coverage for each
child.
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Life and Accident
Quick Glance — Dependent Life Insurance Options:
Spouse/Domestic Partner Supplemental (Supp) Life Insurance
and Child Supplemental Life Insurance
Covered Person
Coverage Options
Rules
Waive Coverage
Spouse or qualified
domestic partner (cost
is based on spouse or
domestic partner’s age)
$5,000
$10,000
$25,000
$50,000
$75,000
$100,000
$200,000
Coverage cannot be more than 100% of your Basic Life
Child(ren)
$3,000 each child
$5,000 each child
$10,000 each child
$20,000 each child
Coverage cannot be more than 100% of your Basic
Administrator
Insurance combined with your Employee Supplemental Life
Insurance coverage amount, if enrolled. You can elect spouse/
domestic partner Supplemental Life Insurance without
electing employee Supplemental Life Insurance coverage.
Evidence of Insurability (EOI) is required for:
Coverage in excess of $50,000
If you have no Supplemental Life Insurance coverage on your
spouse or domestic partner today but elect coverage fo 2013,
EOI is required
Increases in current coverage of more than one level up to
$50,000 (for example, increasing coverage from $5,000
to $25,000) or any increase over $50,000
Life Insurance combined with your Employee Supp Life
Insurance coverage amount, if enrolled. You can elect Child
Supplemental Life Insurance without electing Employee
Supp Life Insurance coverage.
If both parents work at CenturyLink, only one can purchase
Supp Life coverage for their child(ren). You cannot cover the
same dependent child(ren).
Evidence of Insurability (EOI) is not required.
MetLife
Note: If you elect an amount of coverage that requires Evidence of Insurability (EOI), your current
election and cost will remain in force until your EOI form is submitted and approved. Coverage will
go into effect the first of the following month from the date of approval from MetLife. If the form is not
submitted by the deadline provided, your request will not be considered and you will be required to
request the change again. You must be actively at work for dependent supplemental life insurance
coverage to take effect. Dependent coverage will not be effective until you resume active work.
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Life and Accident
Need More Information?
Visit the CenturyLink Health
for an estimator tool you can use to
assist you in determining how much
life insurance you may need.
If you have questions about the life
insurance coverage options, contact
the CenturyLink Service Center at
(800) 729-7526.
If you apply for life insurance coverage that requires EOI and a death
occurs within two years of the approved EOI application, the life insurance
carrier reserves the right to investigate the statements made on the EOI
application before life insurance proceeds are paid. If it is determined that
accurate information was not provided at the time of the application, life
insurance proceeds will be reduced to the amount prior to your request
that required EOI. No statement made by an individual, relating to his or
her insurability for an initial, increased or additional amount of insurance,
will be used in contesting the validity of that insurance, after such initial,
increased or additional amount of insurance has been in force for a period
of two years during the individual’s lifetime.
In addition, if your spouse/domestic partner is confined due to illness
or injury, coverage does not take effect until he or she is no longer
incapacitated. You must notify the CenturyLink Service Center if this
occurs. If this is the case, the increase premium for spouse/domestic
partner Supplemental Life will be credited on a future paycheck and will
not resume until the coverage takes effect.
Basic Accidental Death & Dismemberment
(AD&D) Insurance
Basic Accidental Death & Dismemberment (AD&D) Insurance is provided to
you automatically and at no cost. Full-time employees receive basic AD&D
coverage equal to 1x eligible pay (Basic Annual Salary + Target Incentive
Pay). AD&D pays full benefits for death and partial benefits for paralysis or
loss of a limb(s), eyesight, speech or hearing that occurs within 365 days
of a covered accident. Certain travel assistance services are also available,
including access to emergency medical, informational, legal or personal
assistance while traveling more than 100 miles from home. Call Zurich Travel
Assistance at (800) 263-0261 to access these services while traveling. Basic
AD&D is administered by Zurich American Insurance Company.1
Supplemental Accidental Death & Dismemberment
(AD&D) Insurance for Employees and Dependents
You may buy additional AD&D coverage for yourself, your spouse/domestic
partner and/or child(ren). This voluntary coverage uses your eligible pay
(Basic Pay + Target Incentive Pay) to calculate the benefit. You cannot be
covered for Supplemental AD&D as both an employee and a dependent
if both you and your spouse/domestic partner are employed by the
Company. In addition, both parents cannot cover a dependent child, if
both are employed by CenturyLink.
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1 Basic
and Supplemental AD&D insurance is issued by Zurich American Insurance Company,
1400 American Lane, Schaumburg, Illinois 60196.
Life and Accident
Quick Glance — Supplemental AD&D Insurance Options for You and
Your Dependents
Covered Person
Coverage Options
Rules
Waive Coverage
You must elect supplemental AD&D coverage for yourself in
order to cover your spouse/domestic partner or child(ren).
Employee
1x Eligible pay
2x Eligible pay
3x Eligible Pay
4x Eligible pay
5x Eligible Pay
6x Eligible Pay
7x Eligible Pay
8x Eligible pay
Maximum AD&D benefit is $2,000,000 per employee.
50% of Employee
Supplemental AD&D
coverage.
Maximum AD&D benefit is $750,000.
Child(ren)
25% of Employee
Supplemental AD&D
coverage.
Maximum AD&D benefit is $100,000.
Administrator
Zurich American Insurance Company
Business Travel Accident Insurance
Business Travel Accident (BTA) Insurance provides benefits for accidental loss of life or limb, or for
permanent paralysis when traveling on Company business or during the relocation process. The Plan
provides a benefit equal to 3x eligible pay (Base Pay + Target Incentive Pay), up to $500,000. The
Company provides this coverage at no cost to you.
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Life and Accident
Tips to Follow
When Designating
a Beneficiary

The
total percentage for
all beneficiaries must be
100 percent for each primary
and contingent (secondary)
beneficiary and plan.

Use
the correct date of birth
format: mm/dd/yyyy.

Social
Security Number is
required for beneficiaries.
You will also need the address
and phone number of any
beneficiaries.

You
may name a person and/or
organization (trust or charity) as
a beneficiary.

If you
are electing a Trust or
Estate as your beneficiary,
please make sure you provide
the Executor information for
who handles the Trust/Estate.

You
are automatically the
beneficiary for dependent
supplemental life insurance
coverage.
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Beneficiary Designation
You can name any individual(s), your estate, almost any organization or your
trust as your beneficiary for Basic Life Insurance, Employee Supplemental
Life Insurance, Basic AD&D Insurance, Supplemental AD&D Insurance and/or
Business Travel Accident Insurance. You can designate or update your
beneficiary at any time online or by calling the CenturyLink Service Center.
If you have Supplemental Life Insurance and/or Business Travel Accident
Insurance, unless otherwise specified, the coverage amount is payable to
the same beneficiary (or beneficiaries) as named for your Basic Life
Insurance in the event of your death. If you have Supplemental AD&D
Insurance, unless otherwise specified, the coverage amount is payable
to the same beneficiary (or beneficiaries) as named for your Basic AD&D
Insurance in the event of your death. You are automatically the beneficiary
for dependent supplemental life insurance coverage.
Designate a Beneficiary Online
Log
on to the CenturyLink Health and Life Benefits website at
www.centurylinkhealthandlife.com.
this is the first time you are accessing the site, click on Register as a
New User and follow the prompts to set up your User ID and password
the first time you log on.
If
the home page, click on Update Your Beneficiary Information
and follow the prompts to make updates as needed. In order for a claim
to be paid timely and accurately, enter all of the information requested,
i.e., Social Security Number, date of birth, address, etc.
From
Please note: Once you enter your beneficiary designations on this site,
you will receive a new beneficiary designation confirmation statement.
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Disability
Short-Term Disability (STD)
Short-term disability (STD) coverage is designed to help active full-time
employees replace a portion of their income should they become ill or
injured. Upon completion of your applicable waiting period, CenturyLink
provides an allowance equal to the premium of your STD coverage. During
the enrollment period, you have the opportunity to choose whether your
premium is deducted on a before-tax or after‑tax basis. If an election is
not made, you will default to an after-tax premium deduction.
New Employees: When you have completed your applicable waiting
period, this option becomes available to you and you will have the
opportunity to elect to have STD premiums paid on a before-tax or
after‑tax basis. You will not be able to change your election until the next
Annual Enrollment period. If an election is not made, you will default to an
after‑tax premium deduction.
Explanation: In the event you are approved for short-term disability leave
benefits, and you choose (or are defaulted into) the after-tax option, your
short-term disability leave benefits will not be taxed at the time you receive
these benefits since your premiums were paid with after-tax dollars.
If you choose the before-tax option for your short term-disability benefits,
these benefits will be taxed at the time of receipt since your premiums were
paid with before-tax dollars.
Disability Benefits

Disability
benefits paid under
the CenturyLink Disability Plan
will be reduced if you receive
disability benefits through other
sources (for example, state
disability benefits or Worker’s
Compensation) except for
benefits provided by personallypurchased disability income
plans. Review the appropriate
Summary Plan Description for
more information.

If you
have questions about
the CenturyLink Disability
Plan, call the CenturyLink
Disability Services Center
(CDS) at (800) 729-7526 and
choose the applicable options.
If you qualify for an STD benefit, here’s a comparison chart that shows
how the benefit would be paid out based on your election. Please note
that this example is for illustrative purposes only, using the new 70 percent
wage replacement benefit calculation.
After-Tax Election
(Default)
Weekly Salary
Estimated Weekly Taxes on STD Premium
STD Benefit Payment
Taxes on STD Payment
Take-Home STD Benefit
Before-Tax Election
$1,000
$1,000
$3
$0
$700
$700
$0
$210
$700
$490
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Disability
You may find the Certificate
of Coverage, Summary Plan
Description and other helpful tools
on HRLink under the Benefits>
Disability Management section.
If you choose the Before-Tax Election, you may supplement your disability
pay with accrued paid time off. You must notify CenturyLink Disability
Services at the time you open your disability claim if you choose to
supplement your disability pay.
While on STD (or leave) you continue to be responsible for all benefit
contribution deductions (for example; medical premiums). If your STD
income does not satisfactorily cover your deductions, your deductions will
be collected upon your return to work. It is your responsibility to ensure
your deductions are accurate based on your benefit eligibility and elections.
Your benefit premiums will be placed into “arrears” during the time in which
your STD income (paycheck) is not sufficient for deductions. Upon return
from leave, any benefit premiums placed into arrears will be deducted from
your first check as a lump sum amount.
Long-Term Disability (LTD) Benefit
Nobody expects a prolonged illness or disabling injury, but it can happen
without warning. That is why CenturyLink offers you the following Long‑Term
Disability (LTD) coverage:
Basic
Long-Term Disability provides 50 percent of eligible pay, not to
exceed $24,000 per month (provided at no cost to you; enrollment is
automatic after a one-year of full-time status waiting period).
Supplemental
Long-Term Disability provides 65 percent of eligible pay,
not to exceed $38,462 per month (you pay the full cost of the additional
15% coverage; enrollment is optional; you are eligible to enroll at the
first Annual Enrollment after completion of one year of service).
Important Note: If you want to elect Supplemental Long-Term Disability
coverage while you are receiving regular treatment or care for a disabling
or chronic condition, or if you are on STD on January 1, 2013, you may
not be eligible. Review the pre-existing condition and actively at work
provisions of the Certificate of Coverage to ensure this is an appropriate
option for you to select at this time.
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Disability
Medical and Life Insurance Coverage
After LTD Begins
Medical
Coverage: Continues for three years from the beginning of
short-term disability and then you are offered COBRA.
Life
Insurance Coverage: Continues for three years from the beginning
of short-term disability.
How It Works
Disability coverage can provide income protection in cases of sickness
or injury that prevent you from working. The LTD benefit is based on
your eligible pay — which is your monthly rate of earnings, plus the merit
increases and target incentive compensation averaged over the preceding 12
months. Basic and Supplemental Long-Term Disability benefits begin after
you exhaust your Short-Term Disability benefit and are approved for LTD.
Supplemental Disability Enrollment —
Important Rules to Know
If
you declined Supplemental LTD coverage during the first year you
were eligible to enroll during Annual Enrollment and wish to enroll in
a subsequent Annual Enrollment year, you must submit Evidence of
Insurability (EOI) by completing the Supplemental LTD EOI form that will
be sent to you after Annual Enrollment closes on November 21, 2012.
If
you are required to complete Evidence of Insurability (EOI) for 2013
Annual Enrollment and do not respond by February 28, 2013, your
request for coverage will not be considered and you will not be enrolled
in the Supplemental LTD plan option, even if you submit your EOI after
February 28, 2013 and your EOI is approved.
If
you were hired in 2012, you are not eligible for Basic LTD until
you have completed one year of service. You will not be eligible to
enroll for the Supplemental LTD plan option until the 2014 Annual
Enrollment period.
If
you are on STD on January 1, 2013 and attempted to enroll in the
Supplemental Disability benefit during Annual Enrollment, you will not
be eligible to enroll until you return to work and during the next Annual
Enrollment period. EOI rules apply.
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Disability
Supplemental Disability Premium Rates
If you are eligible and decide to elect the Supplemental LTD Plan, your
monthly premium rate for this Plan option is indicated in the table below.
Check to see if you have satisfied the applicable eligibility waiting period for
coverage. Premiums for the Supplemental LTD Plan option will be deducted
directly from your paycheck. If you do not enroll in the Supplemental LTD
Plan, you will automatically be insured under the Basic LTD Plan with no
premium cost to you.
Legacy Savvis Employees with a 270 day (nine-month) benefit waiting
period, your rate per $100 of monthly covered payroll is $0.249: To
calculate your estimated biweekly premium for coverage under the
Supplemental LTD Plan, use the following formula:
Enter your biweekly predisability earnings, not to
exceed $17,752.
Line 1:
Your biweekly premium rate is .00249
Line 2:
Multiply the amount on Line 1 by the amount on line 2,
and enter total here
Line 3:
The amount on Line 3 is your estimated biweekly premium for coverage
under the Supplemental LTD Plan.
If you are not actively at work (for example, you are out on leave or short
term disability on January 1, 2013) you are not eligible to enroll in the
Supplemental Disability Plan option until you return to work and during the
next Annual Enrollment period. EOI rules apply.
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Disability
Quick Glance — Long-Term Disability Benefits
Basic Long-Term Disability 50%
Supplemental Long-Term Disability 65%
Eligible after one year of full-time service
Eligible at first Annual Enrollment after one
Provides a maximum monthly benefit of
year of service; coverage elected after that
will be subject to Evidence of Insurability
Provides a maximum monthly benefit of
65% of your eligible pay
$25,000 maximum monthly benefit when
combined with Basic Long-Term Disability
Minimum monthly benefit will be the greater
of $100 or 10 percent of the benefit based
on monthly income loss before the deduction
of other income benefits
Pre-existing condition limitations apply
Actively at work provisions apply 1
Benefits are offset by certain other income
You pay the full cost of the additional
15% of supplemental coverage on an
after‑tax basis
Administrator is Standard Insurance
Company
50 percent of your eligible pay
$12,000 maximum monthly benefit
Minimum monthly benefit will be greater of
$100 or 10 percent of the benefit based on
monthly income loss before the deduction of
other income benefits
Pre-existing condition limitations apply
(12 months prior to effective date of coverage)
Actively at work provisions apply 1
Benefits are offset by certain other income
Company pays the cost of this coverage
Administrator is Standard Insurance
Company
1 You
must be capable of Active Work on the day before the scheduled effective date of your insurance.
While on LTD, you continue to be
eligible to receive certain benefits
for a limited amount of time. For
further details, please see the
Summary of Material Modification
and Summary Plan Descriptions for
the health, life and pension plans.
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Commuter Spending Account
Tip: Enroll
$ Saving
in the Commuter
Spending Account

To
enroll, log onto the
CenturyLink Health and Life
Benefits website at www.
centurylinkhealthandlife.
com. Click on the Save on
commuting expenses message
in the upper right of the screen
and follow the prompts.

You
can notify Your Spending
Account of your decision to
enroll or stop participating in the
Commuter Spending Account at
any time.

Enrollment
or changes to your
Commuter Spending Account
must be received by the tenth of
the month prior to the month you
want the change to take effect
(for example, by January 10 for a
February change or election).
Interested in taking mass transit to work and saving some money
along the way? Do you want to drive to work but save on parking
expenses? If so, enroll in the Commuter Spending Account to pay
for your mass transit and parking expenses with before-tax money.
Here’s how the program works:
Mass
Transit Expenses: Set aside up to $1251 before-tax per month for
mass transit purchases, including passes, fare cards or vouchers for the
bus, train, subway or vanpool. If you participate, make your purchases
online at the Your Spending Account website. Go to the CenturyLink
Health and Life Benefits website at
www.centurylinkhealthandlife.com. Click on the Your Spending
Account link under the Other Benefits tab. Reduce your environmental
impact while saving money by participating in this important program.
Follow the instructions shown to enroll.
Parking
Reimbursements: If you drive to work, set aside up to $240
before-tax per month in 2013 to be reimbursed for parking expenses
including parking vouchers, direct pay parking and before-tax cash
reimbursement. Simply enter your claim online, then print a copy of
the claim form, sign it and fax it to Your Spending Account within
180 days of the expense date. You may also choose to have Your
Spending Account pay your parking provider directly.
Consider Commuter Check Cards
While you’re enrolling in the Commuter Spending Account, you might
consider ordering a Commuter Check Card to make paying for your
commuter expenses even easier. There are two types of cards — one for
transit and one for parking expenses. You can order one or both. The Transit
Card is accepted at transit agencies, transit retail centers and vending
machines for the purchase of things like transit passes, tickets, fare cards
and vanpool passes. The Parking Card is accepted at any parking facility
that accepts MasterCard for payment. You decide how much to load to
the card each month, or you can set up a recurring amount to have it done
automatically. Using the cards is fast, convenient and simple.
Note: Enrollment for the Commuter Spending Account is a separate election
from enrollment in other benefits during the Annual Enrollment period. While
you can enroll for the Commuter Spending Account between November 21,
2012 and December 10, 2012 for your account to become effective in January,
you can also enroll at anytime during the year. Note that elections or changes
must be made prior to the tenth of any given month to be effective the first of
the following month. See the Saving Tip on this page for more information.1
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1C
ommuter Spending Account Limits for 2013 — In 2012, the monthly transit purchase limit for commuter
spending accounts was $125 while the pre-tax parking limit was $240 per month. These limits are defined
by the IRS and are subject to change — CenturyLink has no control over them.
Other Benefits
CenturyLink Benefits Provided at No Cost to You
Employee Assistance Program (EAP)
Another way to stay healthy is by limiting the stress in your life. That’s where
the Employee Assistance Program can help.
The Employee Assistance Program offers you and your dependents
professional and confidential counseling services at no cost to you. Get
information and referrals to help you with big decisions about childcare,
eldercare, education, legal services and more.
The EAP will be administered by ValueOptions in 2013.
Legal Services
Access
to over 22,000 attorneys in the U.S. and Canada
Free
30-minute telephonic or face-to-face consultation with a
state-specific attorney per separate issue, per year
Ability
to retain the same attorney for ongoing representation at
a 25 percent discounted rate
To access the Employee
Assistance Program...
Call (800) 803-3737 or log onto
www.achievesolutions.net/
centurylink.
Any time, any day, professionals
are there to help when you need
it most.
Healthcare Advocacy
Services
Have an issue with a healthcare
claim? Need help accessing
healthcare services? See page 43
for assistance with your questions.
Help
with a variety of issues such as separation and divorce,
living wills, criminal matters and document preparation
Mediation Services
Access
to over 2,000 professional mediators
Free
30-minute telephonic or face-to-face with a qualified mediator
per separate issue, per year
Referrals
for face-to-face professional mediation at 25 percent below
normal fees
Help
with a variety of issues such as child custody, child support,
debt division, inheritance disputes and property division
Financial Services
Telephone-based
financial information from credentialed financial
professionals including licensed CPAs and Certified Financial Planners
Up
to 30-minutes of telephonic consultation per separate issue, per year
Consultation
on issues such as financial planning, investments,
credit and collections, taxes, home buying, recovering from debt
and school funding
Referrals
to debt counseling and consolidation services
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Voluntary Lifestyle Benefits
Lifestyle Benefits… 2013 Choices to
Make Your Life Easier
You can enroll in the CenturyLink Lifestyle Benefits Program March 18,
2013 through April 11, 2013. Lifestyle Benefits will provide:
Group
discounts for CenturyLink employees, including online
shopping with national and local merchants, that can save you money
on everything from dinner to clothing to televisions, and much more.
Options
for group coverage, such as accident and critical illness
insurance, universal life with long term care rider, pet, legal and
gap insurance.
Some of the Voluntary Lifestyle Benefits offered
will include:
Voluntary Benefits1
Enrollment
Auto and Home Insurance
Enroll anytime
Accident Insurance
Enroll upon hire or during Annual Enrollment
Critical Illness Insurance
Group Legal Plan
Online Banking
Enroll anytime
Universal Life Insurance
with Long Term Care Rider
U.S. Savings Bonds
Series EE bonds offered through payroll deductions; see
your local HR business partner
Veterinary Pet Insurance
529 College Savings Plan
Enroll anytime
You will receive information about enrolling in voluntary benefits in
February 2013.
Important Note: This program is not a Company-sponsored plan or
benefit. It is not a “plan” covered under the federal law known as ERISA.
The Company has simply chosen to allow certain vendors to make
programs available to CenturyLink employees, but please be advised that
this is a voluntary program and only you can decide whether the benefits
provided by this program are appropriate for you and your family. You
are encouraged to research all suitable alternatives and consult with your
personal advisors. The Company is not able to provide you with advice
regarding the program. Your participation is your decision, completely
voluntary and at your own expense.
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1 Voluntary
Lifestyle benefits are an arrangement between you and the company/vendor providing the program, not
CenturyLink. CenturyLink does not sponsor or endorse any particular vendor or product.
Important Things to Know about Your
2013 Benefit Plan Option Costs
Here are a few additional important points to understand about the cost of
your CenturyLink Medical Benefit Plan Options.
Your
medical premium deduction is determined using your base
annual salary.
Benefit
premium deductions for some plans are based on factors that
could change during the year, specifically base pay and age. Base
pay changes impact premiums for medical, employee supplemental
life, supplemental LTD and supplemental AD&D. In addition, your
supplemental life and dependent life for your spouse/domestic partner
would be impacted if either of you has a birthday that puts you in a new
age bracket.
All
medical, dental and vision premium deductions are paid with
before‑tax contributions, except the portion of the cost for a domestic
partner (if applicable). The value of the coverage provided to a domestic
partner (and his or her child(ren) under the Plan will be imputed as
additional taxable income and will be subject to applicable federal,
state and local income taxes and FICA. To clarify the way contributions
work for domestic partner coverage, participants with a covered
domestic partner will pay the normal Employee plus Spouse premium
on a before‑tax basis. Then, they will have the full cost of coverage
for a single person imputed. If they cover a domestic partner with
children, they would pay the normal Employee plus Family premium on a
before-tax basis and have the full cost of coverage for Employee plus
Child(ren) imputed. Domestic partner benefits are subject to imputed
income under federal tax law. The value of the coverage provided to
a domestic partner (and his or her child(ren)) under the Plan, will be
imputed as additional taxable income and will be subject to applicable
federal, state and local income taxes and FICA. Your supplemental life
insurance, AD&D and LTD benefit premium deductions are paid with
after-tax contributions. Your STD coverage can be paid with before-tax
or after-tax contributions — you decide.
Deductions
are taken equally over 26 pay periods. However, you could
experience a retroactive benefit deduction based on your effective date.
In addition, the payroll schedule will also impact when the retroactive
benefit deduction will process, if applicable.
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Important Things to Know about Your
2013 Benefit Plan Option Costs
Waiving Medical Coverage
If you elect to waive medical/prescription drug coverage with CenturyLink,
you may be eligible for a $750 annual Waived Medical Coverage Rebate,
paid equally over 26 pay periods in 2013. You must elect to waive medical/
prescription drug coverage during the Annual Enrollment period and this
status must remain in effect for the entire 2013 plan year, unless you have a
change due to a Qualified Life Event.
Waiver of Medical Rebate Credit
In certain cases, in order to be eligible for dependent medical coverage in
another employer’s plan, employees would not be able to receive credit
for waiving coverage under the CenturyLink Healthcare Plan. Therefore, in
2013, CenturyLink has added a new Qualified Life Event that allows you to
opt out of our Waived Medical Rebate Credit. To request this new “Waive
Opt‑Out Option,” call the CenturyLink Service Center within 45 days of
learning that the other employer’s plan will not allow you to receive credit
for waiving CenturyLink coverage. After processing, your paycheck will not
show a credit for the amount of the credit.
If you received the waive rebate and are requesting to remove the waive
rebate, it will be retroactive to the event date. Therefore, you may see
after processing has occurred, a deduction of the waive rebate credit.
For example, if you have already had a per pay period amount of $28.85
credited on your Pay Period #1 paycheck and are asking to remove the
credit, it will be based on the event date, not on a go-forward basis.
Remember that waiving medical coverage means you are also waiving your
prescription drug plan coverage since they are bundled.
Note: If you waive medical coverage to be covered by another CenturyLink
employee (husband/wife/domestic partner), you are not eligible for the
Waived Medical Coverage Rebate. In addition, if you are out on Military
Leave (without pay) or another form of leave (without pay), you are not
eligible for the waived medical coverage rebate.
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Use the Tools and Enroll
Enroll Online — November 5 – November 21, 2012
Use the CenturyLink Health and Life Benefits website at
www.centurylinkhealthandlife.com. See detailed online enrollment
instructions on page 81.
first time you visit the website, click on Register as a New User
on the Log On page and follow the prompts to set up your User ID and
password.
The
you’re logged on, you’ll see the Action Needed announcement
at the top of the page. Look for Make Your Annual Enrollment Choice
and click Enroll.
Once
Follow
the easy step-by-step process to make your choices and enroll in
your benefits for 2013. The system will prompt you to review and update
(if needed) your dependent(s) and beneficiary information as you go
through the process.
Once
you are finished and have saved each enrollment option change,
you should print a copy of your completed enrollment information for
your records. If you have a preferred e-mail address on file, you will
receive an e-mail notification indicating you’ve saved one or more
elections. The e-mail will contain a link that you can use to access
your enrollment elections.
You will receive a paper Confirmation Statement in December, after Annual
Enrollment ends.
Enrollment is from
November 5 through
November 21, 2012
Visit the CenturyLink Health and
Life Benefits website at www.
centurylinkhealthandlife.com to
review the plans that are available
to you and their associated costs,
as well as plan comparison
information. You may also call
the CenturyLink Service Center
at (800) 729-7526 to request a
paper copy of these materials.
Want to Participate in
a Flexible Spending
Account for 2013?
Remember, you must elect to
participate each year — your FSA
elections from 2012 will not roll
over to 2013. See page 52 for
more information on FSAs.
Please review this statement carefully and if it is not accurate, call the
CenturyLink Service Center immediately to make any updates.
Important Note! CenturyLink Service Center Representatives will be
available to answer your questions throughout the enrollment period.
To speak with a Representative about enrolling, you must call before
Wednesday, November 21 at 6:30 p.m. Central time or enroll through
the website before 11:59 p.m. Central time.
REMEMBER: If you don’t actively enroll, you will default to NO COVERAGE
other than company-provided options.
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Use the Tools and Enroll
The CenturyLink Health and Life Benefits website at
www.centurylinkhealthandlife.com provides a simple, step-by-step
process for enrolling in your benefits. Each step offers guidance or
tools to help you make your decisions for the 2013 benefits that best
meet your needs.
Step 1 – Learn What’s New and Changing
Find out what’s new or changing in your benefits for 2013.
Step 2 – Review Your Healthcare Costs
Estimate and compare what you might pay out-of-pocket for
medical services in 2013.
Step 3 – Compare Coverage
Compare the costs of deductibles, copayments, coinsurance,
and other details of the plan options you are eligible for.
Step 4 – Find a Doctor
Whether you want to see if your doctor is in the plan option you’re
considering or you’re looking for a new provider, you’ll find help here.
Step 5 – Consider a Spending Account
Estimate your contribution needs for either the Healthcare or
Dependent Care FSA with this helpful tool (excluding Long-Term
Disability and COBRA participants).
Step 6 – Enroll in your Benefits
This final step will walk you through everything you need to do to
enroll in your 2013 benefits.
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Enroll Now in Your 2013 Benefits
Easy Steps for Enrolling Online
1. Go to www.centurylinkhealthandlife.com and select Log On.
Creating Your User ID
and Password
1. C
lick on “Register as a
New User.”
2. Y ou will be asked to confirm
your identify and will need the
following information.

Date
of Birth (mmddyyyy)

Last
Four Digits of Social
Security Number

Zip
2. If you have used the CenturyLink Health and Life Benefits website in the
past, enter your User ID and Password.
Code
3. The system will confirm your
information and prompt you to
create a User ID to be used for
future logins.
4. You will be prompted you
to create a password that is
composed of a minimum of
8 and maximum of 20 alpha
numeric characters.
3. Forgot your password? Click I Forgot My Password and enter the
information needed to reset it.
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A Note About Privacy.
The protection and security of your
personal information is of primary
importance to CenturyLink. That’s
why we, along with the benefits
administrator, have implemented
various security measures and
policies to help reduce the risk
of unauthorized processing
or disclosure of your personal
information. You can also help by
protecting the confidentiality of
your User ID and password for
accessing the CenturyLink Health
and Life Benefits website. Keep this
information safe and don’t share it
with anyone. Never use your Social
Security Number as your password.
Together, we can make sure your
personal information stays safe
and secure.
First, confirm your identity…
…Then reset your password
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4. First time using the website? Click on Register as a New User.
First, confirm your identity, then create a password.
5. After you log in, see Action Needed! to start enrolling or update your
beneficiary information.
Note: Be sure your beneficiary information is current. You can choose
or update your life insurance beneficiaries by selecting one of the links
on the home page.
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6. If you choose to review or change your beneficiaries, you can do
that here.
Note: This page will look differently, depending on the plans for which
you are eligible.
7. Ready to get started? Click Enroll.
8. The Enroll link takes you to this step-by-step page with helpful
enrollment resources all in one place.
Note: This page may look differently, depending on the plans for
which you are eligible.
9. When you are ready, click Enroll in Your Benefits then Enroll Now
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10.Review your choices and associated costs, and make your selections.
Note: This is a sample page and does not show your eligible options
or costs. When you enroll, you will only see the plans for which you are
eligible and your costs.
11.After you have made all of your choices, click Complete Enrollment.
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Want a Paper Copy
of the Summary Plan
Description and/or
Summary of Material
Modifications?
You can find these documents
online at the CenturyLink Health
com or by calling the
CenturyLink Service Center
at (800) 729-7526.
12.Look for the Completed Successfully message and print a copy for
your records.
Forgot Your User ID or Password?
As mentioned above, you must register as a new user the first time you
access the site to set up a User ID and password. In the future, if you
forget your User ID or password, click on the appropriate link under Log
On Help on the Log On page and follow the prompts. You’ll receive your
log on information within 15 minutes, if you have a valid email address on
file. If you don’t, your log on information will be mailed to the address on
file. You can also call the CenturyLink Service Center at (800) 729-7526
for assistance. (Note: It can take up to 10 days to receive your log on
information through the mail.)
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Glossary of Terms
The CenturyLink Service Center — Your first source for information
about benefits delivered in an easy-to-use, accurate and consistent way.
Connect with the CenturyLink Service Center through the toll-free number
(at (800) 729-7526 from 8:30 a.m. to 6:30 p.m. Central time M-F) or via
secure e-mail from the CenturyLink Health and Life website
www.centurylinkhealthandlife.com.
Healthcare Spending Card — A UHC debit card you receive when you
enroll in the CDHP. It works with your HRA (health reimbursement account)
and allows you to pay eligible healthcare expenses directly from your HRA
or Healthcare Flexible Spending Account (FSA) without submitting paper
claims.
Consumer Driven Health Plan (CDHP) — A self-funded health plan option
that lets you play a larger role in how your healthcare dollars are spent by
using a health reimbursement account (HRA) — along with a traditional
health coverage component. It gives you the security of medical coverage,
with the control of paying expenses at your discretion through an HRA
funded by the Company.
Copay — A flat dollar amount you pay for covered services usually at the
time services are received.
Deductible — The amount you pay out-of-pocket for eligible expenses
before the Plan begins paying benefits.
Eligible Expense — Any service or supply that is approved for coverage
under the respective plans.
Health Reimbursement Account (HRA) — A component of the Consumer
Driven Health Plan (CDHP) funded by CenturyLink for participants to use
first to pay for medical and prescription drug expenses.
Health Savings Account (HSA) — A tax-free savings option for participants
enrolled in the High Deductible Health Plan (HDHP) to pay and save for
qualified healthcare expenses. You can contribute to an HSA until you
become eligible for Medicare. The money you contribute to an HSA is
yours, and the account goes with you if you retire or leave CenturyLink.
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87
Glossary of Terms
High Deductible Health Plan (HDHP) — A self-funded health plan option
that has a traditional health coverage component with a deductible amount
that meets the IRS requirements for high deductible health plans. Due to
the higher deductible, you have the option of opening a Health Savings
Account (HSA) that you can use to save and pay for qualified healthcare
expenses.
Limited Healthcare Flexible Spending Account (Limited FSA) — A
Flexible Spending Account for participants enrolled in the High Deductible
Health Plan. Account is limited to eligible dental and vision expenses and
may not include medical deductibles or coinsurance.
Out-of-pocket Maximum — The limit on the total coinsurance and
deductible you will pay in any calendar year. Once out-of-pocket
maximums are reached for a calendar year, plans usually pay 100 percent
of covered expenses for the rest of the calendar year (up to Reasonable
and Customary limits, if you go outside the network).
Preferred Provider Organization (PPO) — A self-funded medical benefit
option that uses large networks of doctors, hospitals and other healthcare
professionals to provide services at discounted rates. PPO plan options
give participants the flexibility to use physicians and other professionals
who are not part of the PPO network, but at higher out-of-pocket costs.
Reasonable & Customary — The charges usually set by the Plan
administrator based on charges billed for similar treatments or services
in a particular geographic area, such as within a zip code grouping.
Traditional Healthcare Flexible Spending Account (FSA) — A Flexible
Spending Account for participants enrolled in the PPO or CDHP medical
benefit option, or with no medical option through CenturyLink. Account may
be used for eligible medical, dental or vision expenses.
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Summary of Benefits and
Coverage Availability
Summary of Benefits and Coverage Availability
The health benefits available to you represent a significant component of
your compensation package. Health benefits provide important protection
for you and your family in the case of illness or injury.
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 in a standard format, to help you compare
across options.
The SBC is available on CenturyLink Health and Life Benefits website
during your enrollment period. You can view the SBC by opening the Plan
Information page, as follows:
Log
into the Health and Life Benefits website at
Open
the Health and Life Benefits tab
From
the drop down menu, select Plan Information
Then
choose the Summary of Benefits and Coverage you’d like to review.
A paper copy is also available, free of charge, by calling the CenturyLink
Service Center at (800) 729-7526 and pressing the applicable option to
speak to a representative. Representatives are available, Monday through
Friday from 8:30 a.m. to 6:30 p.m. Central time.
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89
Important Legal
and Required Notices
Enroll in your 2013 benefit
options by the deadline!
This is your time to evaluate your
benefit options and actively enroll
in the benefit options that will best
meet your needs and the needs of
your family.
The Annual Enrollment
period is November 5 –
November 21, 2012.
Be sure to enroll in your 2013
benefit options by November 21.
If you don’t actively enroll, you will
be covered ONLY by companyprovided benefits (Basic Life
Insurance, Basic AD&D Insurance,
after-tax STD and Basic LTD). You
will not have the opportunity to
change your 2013 coverage unless
you experience a Qualified Life
Event (QLE) during 2013.
Summary of Material Modifications
You may receive a Summary of Material Modifications for the CenturyLink
Medical Plan and the CenturyLink Group Life Insurance Plan before the end
of 2012.
This Enrollment Guide presents only the highlights of certain benefits available
to eligible employees of CenturyLink and its affiliated companies, and their
eligible dependents. The full details and provisions are provided in the official
formal plan documents and/or certificates. If there is any conflict between
the terms of the Plan documents and this document, the terms of the Plan
documents will govern. CenturyLink has reserved to the Plan Administrator
the right to interpret and resolve any ambiguities in the Plan or any document
relating to the Plan.
Right to Amend
Plan benefits are determined by CenturyLink in its sole discretion and
CenturyLink has reserved the right in its sole discretion, to change, modify,
discontinue or terminate the Plan and/or any of the benefits under the
Plan and/or contribution levels, with respect to all participant classes,
retired, or otherwise, and their beneficiaries at any time without prior
notice or consultation. The Plan Administrator may adopt, at any time, rules
and procedures that it determines to be necessary or desirable with respect
to the operation of the Plan.
Remember: You will receive a
paper Confirmation Statement in
December, after Annual Enrollment
ends. Please review this statement
carefully and if it is not accurate,
call the CenturyLink Service Center
immediately to make any updates.
Important Note! CenturyLink
Service Center Representatives
will be available to answer
your questions throughout the
enrollment period. To speak with
a Representative about enrolling,
you must call before Wednesday,
November 21 at 6:30 p.m. Central
time or enroll through the website
before 11:59 p.m. Central time.
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Important Legal
Women’s Health and Cancer Rights Act
This
notice is provided to you in compliance with the federal law entitled
the Women’s Health and Cancer Rights Act of 1998 (the “Act”). The plan
provides medical and surgical benefits in connection with a mastectomy.
In accordance with the requirements of the Act, the Plan also provides
benefits for certain reconstructive surgery.
In
particular, the plan will provide, to an eligible participant who is
receiving (or who presents a claim to receive) benefits in connection
with a mastectomy and who elects breast reconstruction in connection
with such mastectomy, coverage for: (1) reconstruction of the breast
on which the mastectomy has been performed; (2) surgery and
reconstruction of the other breast to produce a symmetrical appearance;
and (3) prostheses and treatment of physical complications associated
with all the stages of mastectomy, including lymphedemas, in a manner
determined in consultation with the attending physician and the patient.
As
with other benefit coverages under the Plan, this coverage is subject
to each medical benefit option’s annual deductible (if any), required
coinsurance payments, benefit maximums, and copay provisions that
may apply under each of the benefit options available under the Plan.
You
should carefully review the provisions of the Plan, the medical
benefit option in which you elect to participate, and its Summary Plan
Description and Summary of Material Modifications (if any) regarding any
applicable restrictions.
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91
Important Legal
Newborns’ and Mothers’ Health Protection
Act (NMHPA)
As required by the Department of Labor, CenturyLink is providing this
notice about the Newborns’ and Mothers’ Health Protection Act.
Group health plans and health insurance issuers generally may not, under
federal law, restrict benefits for any hospital length of stay in connection
with childbirth for the mother or newborn child to less than 48 hours
following a vaginal delivery, or less than 96 hours following a Cesarean
section. However, federal law generally does not prohibit the mother’s
or newborn’s attending provider, after consulting with the mother, from
discharging the mother or her newborn earlier than 48 hours (or 96 hours
as applicable). In any case, plans and issuers may not, under federal law,
require that a provider obtain authorization from the plan or the insurance
issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours
as applicable).
Please contact Member Services of your medical provider for more
information.
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Important Legal
Health Insurance Portability and Accountability
Act (HIPAA)
Under the Special Enrollment rules under HIPAA, you may enroll yourself
and eligible dependents in the Health Plan upon the loss of other coverage,
referred to as “the other plan”, to include the following:
Termination
of employer contribution toward other coverage;
Moving
out of a service area if the other plan does not offer other
coverage;
Ceasing
to be a dependent, as defined in the other plan;
Loss
of coverage to a class of similarly situated individuals under
the other plan (e.g., when the other plan does not cover part-time
employees).
If you spouse or other dependent has special enrollment rights, you may
enroll and make changes to your enrollment in any health plan benefit
option available to you based upon your home ZIP code and plan service
areas within 45 days following the qualifying event. For example, if you
have single coverage in a CenturyLink benefit option, and your spouse
loses coverage under his/her employer’s plan and has special enrollment
rights, both you and your spouse may enroll in any of the CenturyLink
benefit options available to you, provided your dependent verifies his or her
eligibility for the CenturyLink Medical Plan. Refer to page 12 for information
about how to verify your dependent’s eligibility for coverage.
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93
Important Legal
What Is a Qualified Medical Child Support Order
(QMCSO)?
A QMCSO is a court order that mandates that one parent be obligated to
provide coverage under an employer’s group health plan to a minor child
at that parent’s expense. This allows your minor child to be enrolled in a
group health plan mid-year. The child remains enrolled in the plan until
a new court order removes the QMCSO or the child becomes ineligible
for coverage under the plan’s terms (for example, the child reaches age
26 or the parent is no longer eligible). A National Medical Support Notice
(NMSN) is issued by a state agency instead of a court but is equivalent to
a QMCSO. Typically, a custodial parent will obtain a QMCSO or NMSN as
part of a child support arrangement.
If
you have a QMCSO, you must send a copy of it to the CenturyLink
Service Center.
If
you have currently waived coverage under the Plans, and the
QMCSO requires your dependent child(ren) to be covered, you will be
automatically set up with default coverage (PPO Medical and Basic
Dental). You will have healthcare deductions at the employee & child(ren)
coverage level.
If you have questions regarding a QMCSO, where to send your QMCSO or
whether you have one on file, contact the CenturyLink Service Center at
(800) 729-7526.
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Important Legal
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 are eligible
for health coverage from your employer, your state may have a premium
assistance program that can help pay for coverage. These states use funds
from their Medicaid or CHIP programs to help people who are eligible for
these programs, but also have access to health insurance through their
employer. If you or your children are not eligible for Medicaid or CHIP, you
will not be eligible for these premium assistance programs.
If you or your dependents are already enrolled in Medicaid or CHIP, you
can 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, you can contact your state Medicaid or CHIP office or dial
(877) KIDS NOW [543-7669] or www.insurekidsnow.gov to find out how
to apply. If you qualify, you can ask the state if it has a program that might
help you pay the premiums for an employer-sponsored plan.
Once it is determined that you or your dependents are eligible for premium
assistance under Medicaid or CHIP, as well as eligible under your employer
plan, your employer must permit you to enroll in your employer plan if you
are not already enrolled. This is called a “special enrollment” opportunity,
and you must request coverage within 60 days of being determined eligible
for premium assistance.
To see which states have a premium assistance program and for
information on special enrollment rights, you can contact either:
U.S. Department of Labor
U.S. Department of Health and Human Services
Employee Benefits Security Administration
www.dol.gov/ebsa
Toll-free (866) 444-EBSA [3272]
Centers for Medicare &
Medicaid Services
www.cms.hhs.gov
Toll-free (877) 267-2323, Ext. 61565
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95
Important Legal
Continuation of Coverage
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA) of
1985, COBRA qualified beneficiaries (QBs) generally are eligible for group
coverage during a maximum of 18 months for qualifying events due to
employment termination or reduction of hours of work. Certain qualifying
events, or a second qualifying event during the initial period of coverage,
may permit a beneficiary to receive a maximum of 36 months of coverage.
COBRA coverage is not extended for those terminated for gross misconduct.
Upon termination, or other COBRA qualifying event, the former employee
and any other QBs will receive COBRA enrollment information. Qualifying
events for employees include voluntary/involuntary termination of
employment, and the reduction in the number of hours of employment.
Qualifying events for spouses or dependent child(ren) include those events
above, plus, the covered employee’s becoming entitled to Medicare,
divorce or legal separation of the covered employee, death of the covered
employee, and the loss of dependent status under the plan rules. If a
QB chooses to continue group benefits under COBRA, he or she must
complete an enrollment form and return it to the Plan Administrator with
the appropriate premium due. Upon receipt of premium payment and
enrollment form, the coverage will be reinstated. Thereafter, premiums are
due on the first of the month. If premium payments are not received in a
timely manner, coverage will be cancelled after a 30-day grace period.
If you have any questions about COBRA or the Plan, please contact the
CenturyLink Service Center at (800) 729-7526.
If You Voluntarily Elect to Drop Coverage
If you voluntarily drop healthcare coverage for yourself or a dependent
during Annual Enrollment, without there being a Qualified Life Event (QLE),
you and/or your dependent will not be eligible for continuation healthcare
coverage under the federal law known as COBRA. Eligibility for COBRA
continuation coverage occurs only in cases of QLEs that are described on
page 15 of this Guide. For more information on what is a QLE, refer to the
Summary Plan Description.
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Quick Reference Chart
Benefit Option
Phone
Online
CenturyLink Service
Center
(800) 729-7526
from 8:30 a.m. to 6:30 p.m.
Central time, M-F.
The CenturyLink Health
and Life Benefits website
CDHP and HDHP
UnitedHealthcare:
(800) 842-1219 all states
except Minnesota, North
Dakota, South Dakota and
western Wisconsin
Medica: (800) 996-2038
in Minnesota, North Dakota,
South Dakota and western
Wisconsin
UnitedHealthcare:
www.myuhc.com
(participant portal)
PPO
UnitedHealthcare:
(800) 842-1219
If you need to direct a
question to UHC and are not
a current UHC participant,
select the “Annual
Enrollment” prompt when
you call.
UnitedHealthcare:
www.myuhc.com
centurylink
(pre-enrollment website available
to non-participants)
Phone numbers
available for enrolled
participants in late
December.
Highmark Blue Cross Blue
Shield: (888) 778-8334
Blues On Call:
(888) BLUE-428
Pre-certification:
(800) 452-8507
Mental Health:
(800) 258-9808
Highmark BCBS:
www.highmarkbcbs.com
Prescription Drug
Program
UnitedHealthcare:
(800) 842-1219
UnitedHealthcare:
www.myuhc.com
centurylink
centurylink
Have questions or
need info?
Visit the CenturyLink Health and
Life Benefits website at www.
centurylinkhealthandlife.com
or contact the CenturyLink Service
Center at (800) 729-7526
from 8:30 a.m. to 6:30 p.m.
Central time, M-F.
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Quick Reference Chart
Benefit Option
Phone
Online
Dental Plans
MetLife:
(888) 356-4191
www.metlife.com/mybenefits
Vision Care Plan
Vision Service Plan:
(800) 877-7195
www.vsp.com
Flexible Spending
Accounts
UnitedHealthcare
(grp#199383):
(877) 311-7849
www.myuhc.com
Life and Accident
CenturyLink Service Center:
(800) 729-7526
N/A
Disability
CenturyLink Service Center:
(800) 729-7526
N/A
Employee Assistance
Program
ValueOptions:
(800) 803-3737
www.achievesolutions.net/centurylink
Note: Once you are enrolled, many of the claims administrator’s websites
enable you to register and log on to check the status of claims, view
eligibility information, print temporary ID cards, have access to educational
materials, view provider directories, view network listings and more.
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Frequently Asked Questions
2013 UnitedHealthcare FAQs
Healthcare Spending Card
(formerly called the Consumer
Accounts Card — CAC)
What is the Healthcare Spending Card?
The Healthcare Spending Card (HCSC) is a special
purpose debit card you may use to pay for eligible
healthcare expenses directly from your Health
Reimbursement Account (HRA) or Healthcare
Flexible Spending Account (FSA) without
submitting paper claims. Eligible expenses may
include such things as pharmacy prescriptions or
office copayments. You may also use the HCSC
to pay for coinsurance amounts when using UHC
network providers. However, you shouldn’t pay
for these expenses until your claim has been
processed by UHC and you know your final patient
responsibility.
Who is eligible for a Healthcare
Spending Card?
First time users: If you enroll in the
UnitedHealthcare Consumer Driven Health Plan
(CDHP) and/or elect a Flexible Spending Account
(FSA) for the first time in 2013, you will receive a
Healthcare Spending Card. If you enroll in both the
CDHP and an FSA, both amounts will be loaded
to one card. If you were enrolled in an FSA with
UnitedHealthcare or the CDHP in 2012, you will
continue to use your current Healthcare Spending
Card. The Card has a four-year duration and should
not be discarded between plan years. You may
continue to use the Card as long as you remain
enrolled in the CDHP or FSA each plan year.
New cards will automatically be issued 45 days
prior to the card expiration date. If you have lost
or misplaced your Healthcare Spending Card,
contact UHC Customer Service at (866) 755-2648
to request replacement cards.
What expenses can be paid from the
HRA? What expenses can be paid from
the Healthcare FSA?
The Health Reimbursement Account (HRA) under
the CDHP is part of the medical plan and may only
be used to cover eligible medical plan expenses
(including prescriptions).
The Healthcare FSA can be used to pay for eligible
medical, prescription, dental and vision expenses
as well as eligible over-the-counter healthcare items
(may require a prescription).
Important: Expenses that are eligible under both
the HRA and FSA will be paid from the HRA first
until your HRA balance is exhausted.
Can I use my Healthcare Spending Card for
dependent day care expenses?
Dependent Day Care FSA money is loaded to the
Healthcare Spending Card on a contribution basis
(as dollars are deducted from your paycheck). The
provider you use must be set up with the MCC
code (the MasterCard device code) that indicates
child care services. If not, you will need to pay for
services out-of-pocket and submit a claim to UHC
for reimbursement.
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How soon can I begin using my Healthcare
Spending Card after I receive it?
Activate your Card as soon as you receive it. Your
Card can be used immediately after activation. If
you activate your Card prior to the effective date of
coverage, the Card will be available for use on the
effective date.
Where can I use my Healthcare Spending
Card for prescriptions?
The IRS has approved the Inventory Information
Approval System (IIAS) as a method for retailers
to identify and substantiate eligible expenses for
debit card transactions. The Inventory Information
Approval System (IIAS) enables participants to
purchase eligible expenses from a broad range
of retailers, increasing the use of the Card and
reducing manual claims processing requirements.
A retailer’s point of sale system identifies eligible
Healthcare FSA/HRA purchases by comparing
the inventory control information (UPC or SKU
number) against the list of restricted eligible medical
expenses as described in IRS Section 213(d). The
IRS states merchants need to be able to identify
213(d) eligible items; however, it is not required
that merchants break out the eligible items by
Prescription and General Healthcare (over-thecounter or OTC). While most merchants will break
this out, there are some that do not. To determine
if a merchant separates prescriptions, look for
a “check mark” in the Supporting Prescription
Subtotal column of the Merchant List found on
www.sig-is.org.
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Important: If a participant uses a merchant that
does not break out Prescriptions and General
Healthcare (OTC), there could be two potential
issues with the Healthcare Spending Card.
Issue
1 — If a participant only has an HRA and
the merchant does not break out the expenses
(i.e., they pass a prescription over as General
Healthcare), the card transaction will decline as
the HRA is only set up to allow prescriptions and
not OTC.
Issue
2 — If a participant has an HRA and FSA
and the merchant passes a prescription as
General Healthcare, the prescription will pay out
of the FSA (versus the HRA) as HRA is only set
up to allow prescriptions and not OTC.
Participants can visit www.sig-is.org and select
the IIAS Merchants PDF link to view a list of
participating merchants. The Merchant List is
updated every two days. The Merchant List
includes four pieces of information — 1) Merchant
Name; 2) Certification Status; 3) Planned Merchant
Implementation Date; and 4) Supporting Prescription
Subtotal. You may use your Healthcare Spending
Card at participating merchants based on the
benefit plans you are enrolled in:
FSA
only — you must use merchants that are
certified and have a status of “Live” in the
Planned Merchant Implementation Date column.
HRA
only or HRA/FSA — you must use
merchants that are certified, have a status of
“Live,” and a “check mark” in the Supporting
Prescription Subtotal column.
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How does the Healthcare Spending
Card work?
It is swiped on a point of sale terminal that accepts
MasterCard. Consumer expense information is
transferred for validation through the MasterCard
network. Authorized amounts transfer directly
from the HRA/FSA to the provider/merchant.
Unauthorized transactions are denied. There is
no PIN required — choose “Credit” at the point
of service.
Important! If you are purchasing prescriptions,
be sure to present your UHC ID card first. Your
Healthcare Spending Card is not an insurance
card — it is a form of payment like any other debit
or credit card. You use your Healthcare Spending
Card for purchasing your prescriptions, not for
validating your coverage.
Will I need to submit receipts to
UnitedHealthcare for expenses purchased
with my Healthcare Spending Card?
No. UnitedHealthcare only requests receipts for
credit returns or forced transactions where the
merchant did not receive an authorization from
MasterCard. For example, if you returned an item
and a credit is applied to your card, UHC would
require a receipt to confirm that the returned item
is an eligible expense. Keep your receipts!! You
should hold on to any receipts for services or items
paid for using your Healthcare Spending Card in the
event UHC does need copies. In addition, the IRS
can require you to provide documentation of these
expenses.
Can I pay for a prescription that is more than
the remaining balance in my HRA with my
Healthcare Spending Card?
The pharmacy can process the amount remaining
in your HRA from the Healthcare Spending Card
and then request a second form of payment for
the remaining balance. You must use a merchant
that is IIAS compliant and has a “check mark”
in the Supporting Prescription Subtotal column
on the Merchant List. If you are also enrolled in a
Healthcare FSA, the remaining balance will be paid
from available FSA dollars.
If no additional funds are available in your HRA or
FSA, you will need to use another form of payment
for your prescription.
How do I submit expenses for
reimbursement from my FSA or HRA if I
don’t use my Healthcare Spending Card?
Claims for medical, dental, vision and prescriptions
are automatically fed to your FSA via electronic files.
The timing varies, but most vendors submit an
electronic file to UHC at least once a month.
Therefore, no reimbursement claim form is
required. In addition, you may set up direct
deposit on www.myuhc.com for both the HRA
(“Medical Reimbursement”) and FSA. If you
need to submit a claim form for reimbursement,
you will use the HRA/FSA claim form and
submit it to UHC. You can obtain this form at
www.myuhc.com or on the CenturyLink intranet
or www.centurylinkbenefits.com.
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What are some reasons a Healthcare
Spending Card transaction may be declined?
(The Card may be declined in the following
situations but this list is not exhaustive)
The
Card is not activated.
You
have both an HRA and FSA and are trying
to use an IIAS merchant that does not have a
“check mark” in the Supporting Prescription
Subtotal column on the IIAS Merchant List.
transaction is not for an eligible service
or it does not match a pre-defined benefit
Copay amount.
Will my 2012 HRA balance be added to my
Healthcare Spending Card in 2013?
Yes. Any remaining HRA balance at the end of
the calendar year will remain on your Healthcare
Spending Card. For example, if you have $500
remaining in your HRA on Dec. 31, 2012 and
receive a new allocation of $1,000 on Jan. 1, 2013,
the amount available on your Healthcare Spending
Card on Jan. 1, 2013 will be $1,500.
The
Can I view my card transactions online?
The
Online access to account information and card
transactions is available via www.myuhc.com.
You can view your current account balance as
well as view account transactions that have been
processed using your Healthcare Spending Card.
transaction is for a non-eligible charge.
The
transaction cannot be substantiated in
real-time at the pharmacy.
The
retailer does not accommodate partial
authorization and the remaining funds in the
account won’t cover the expense.
There
is a problem with the merchant’s card
terminal.
It
is an invalid location, e.g., a gas station or
electronics store.
What if I have been enrolled in a
UnitedHealthcare FSA, but can’t find my
Healthcare Spending Card?
Contact Healthcare Spending Card customer
service at (866) 755-2648 to request a new
Healthcare Spending Card.
You
have a zero balance in your HRA/
FSA account.
If you have a question about a declined transaction,
call the number on the back of your card and
attempt to resolve the issue with the Customer
Service Department.
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Does my Healthcare Spending Card include
both my HRA and FSA dollars?
Yes. If you are enrolled in the CDHP and an FSA,
both the HRA and FSA balances are loaded to
one Healthcare Spending Card. The HRA and
FSA balances are tracked separately and can be
viewed on www.myuhc.com. Remember, if an
expense is eligible under both the HRA and FSA,
the HRA funds will be used first until the account is
exhausted; then the FSA funds will be used.
What is the difference between my
UnitedHealthcare ID card and my Healthcare
Spending Card?
Your UHC ID card is used to show proof of your
CenturyLink group medical plan coverage. The
Healthcare Spending Card is a form of payment
only — just like your own debit or credit card. The
Healthcare Spending Card is not an ID card. You will
need to show your UHC ID card to your provider/
pharmacy and then pay using your Healthcare
Spending Card.
CDHP General Information
Can I choose to have claims paid from my
Healthcare FSA first rather than my HRA?
All eligible claims are paid from the HRA first
(medical and prescription expenses only). If there
are out-of-pocket costs for you, the claim will be
submitted to your FSA and you will be reimbursed.
You do not have the option to change the order of
claims payment. If a claim is an eligible medical/
prescription expense, it falls under the medical plan
and would be paid from the HRA.
When I exceed my $2,000 HRA balance
(family coverage) in the CDHP, how does
the plan work?
You will receive an annual HRA allocation based
on the coverage level you elect (employee only,
employee + spouse/domestic partner, employee
+ child(ren) or employee + family). A $2,000 HRA
allocation is provided to employees who enroll in
the CDHP and elect “employee + family” coverage.
All eligible expenses (up to the allowable amount)
are paid from the HRA first (after network discounts
when using network providers). The deductible
under the CDHP is equal to your HRA allocation
PLUS your Member Responsibility. For “employee
+ family” coverage, your network deductible is
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equal to $3,000 ($2,000 HRA allocation and $1,000
Member Responsibility). In this example, once the
HRA is exhausted, the participant is responsible
for the next $1,000 in expenses at the full cost.
If you contributed to a Healthcare FSA, you may
use your FSA dollars to cover your Member
Responsibility. When the Member Responsibility
is met, the deductible has also been met. After
the deductible is met, the plan begins paying 80
percent of network expenses and 60 percent of outof-network eligible expenses (up to the allowable
reasonable and customary (R&C) amount). You
are then responsible for 20 percent of a network
expense or 40 percent of an out-of-network expense.
You continue paying your 20 percent or 40 percent
until you reach the out-of-pocket maximum. Once
you reach the out-of-pocket maximum, you and
your covered dependent’s claims will be paid at
100 percent for the remainder of that calendar year.
HRA dollars remaining at the end of 2012 will
be rolled into and added to your HRA for 2013
(assuming you elect the CDHP for 2013). Any
remaining HRA dollars at the end of a plan year roll
into the next plan year provided you continue to
enroll in the CDHP and can be used to satisfy the
Member Responsibility and coinsurance.
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Are prescription costs included in my
deductible and out-of-pocket maximum?
Yes. Prescription expenses apply toward the
deductible and out-of-pocket maximum just like
any other medical expense under the CDHP.
How does UHC track employee out-of pocket
expenses? Deductible?
As claims come in to UHC, they check to see
what medical plan option you are enrolled in and
pay claims according to that plan option. If you
are enrolled in the CDHP, UHC applies covered
medical and pharmacy expenses (non-preventive)
to the calendar year deductible and out-of-pocket
maximum. When there is Member Responsibility,
UHC checks to see if you have HRA dollars
available. If so, the claim will be paid from HRA
dollars after applicable network discounts. Each
time a claim comes in, your HRA, deductible and
out-of-pocket maximum balances are updated.
As your HRA balance goes down, you will see the
deductible and out-of-pocket maximum amounts
increase. You can track all of these balances on
www.myuhc.com once you are registered. You can
also download the Health4Me mobile app to your
smartphone or tablet and to check the status of a
claim, deductible and see your account balance.
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Once the participant meets the out-of-pocket
maximum, the CDHP pays 100 percent of
“eligible expenses.” Does this mean the
plan option covers 100 percent of the costs
or the “reasonable and customary” amount?
Yes, the CHDP will pay 100 percent of eligible
expenses (or the reasonable and customary amount
submitted for out-of-network providers) once a
participant has met the out-of-pocket maximum.
Allowable/reasonable and customary expenses
apply when using out-of-network providers only. The
reasonable and customary amount is the average
fee being charged for that particular service in your
area. If you go in for an office visit and the provider
charges $200, but the “reasonable and customary”
fee for an office visit in your area is $150, UHC will
pay $150 and you would be responsible for the
difference ($50). Charges above the reasonable and
customary amount are not covered under the plan
benefits and do not apply toward the deductible or
However, if you have contributed to a Healthcare
FSA, the $50 charge above reasonable and
customary can be reimbursed from your FSA.
Where can I view my HRA and/or
FSA balances?
You can track your HRA and/or FSA balance on
www.myuhc.com. You will need to register on
the UHC website. This only takes a few minutes.
Once you are a registered user, you have access
to view your claims online, check your HRA or FSA
balances, set up direct deposit of your HRA/FSA,
print temporary ID cards, find network providers
SM
and more. You an also Download the Health4Me
Mobile App to your smartphone or tablet and see
how easy it is to find nearby physicians, check
the status of a claim, see your account balance or
speak directly with a nurse.
Once I meet the out-of-pocket maximum,
do all covered dependents receive
100 percent coverage?
Yes. Once the out-of-pocket maximum is met, all
covered eligible dependents receive 100 percent
coverage for the remainder of the plan/calendar
year. Charges above the “reasonable and customary”
amount would still be the participant’s responsibility
even after the out-of-pocket maximum has been met.
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Can I pay dental or vision expenses from
my HRA?
No. Only eligible medical and prescription expenses
can be paid from the HRA. Refer to the SPD for
a list of covered services. Dental, vision and
over-the-counter medications (may require
a prescription) can be reimbursed from your
Healthcare FSA.
Is my HRA prorated if I enroll in the plan
option mid-year or add a new dependent
mid-year? What if I remove a dependent
such as a spouse due to a divorce?
Yes. The HRA, deductible and out-of-pocket
maximum are prorated if you enroll in the CDHP
mid‑year — for example, an employee hired in
June. In addition, if you add a new dependent
during the year that changes the HRA amount, you
will receive additional dollars (prorated) in your HRA
and your deductible and out-of-pocket maximum
will increase.
If you remove a dependent during the year and
your coverage level changes, your HRA will not be
reduced. In addition, your deductible and out-ofpocket maximum will not be prorated.
HSA Questions
What is an HSA?
You can only open an HSA if you participate in a High
Deductible Health Plan. An HSA is a personal bank
account that you own. You can use it to save money,
federal income-tax-free, to pay for qualified medical
expenses. When you have medical expenses,
including those that may apply to your health plan’s
annual deductible, you can choose to pay for them
using the money in your HSA. Or, you can save the
money for a future need — even into retirement.
If you are a full-time active employee, you can
authorize CenturyLink to set up an HSA on your
behalf through OptumHealth Bank. CenturyLink
does not contribute to your HSA.
What is a qualified medical expense?
The Internal Revenue Service (IRS) decides which
expenses can be paid and reimbursed from an
HSA. You can find a list of common HSA-qualified
expenses at www.welcometouhc.com.
What expenses don’t qualify for tax
benefits?
Examples of expenses that do not qualify include
cosmetic surgery, health club memberships, teeth
whitening and over-the-counter medicines purchased
without a prescription. If you use an HSA to pay for
an expense that is not qualified, you will have to pay
taxes on the expense and may also have to pay a
20 percent penalty. So, if the expense was $100,
you would pay an extra $20, plus taxes.
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Do I have to use the bank
my employer chooses?
Is there a limit on how much I can contribute
(deposit) to my HSA?
No. You can open your HSA with any bank of your
choice. OptumHealth BankSM, Member FDIC,
is UnitedHealthcare’s preferred healthcare bank.
OptumHealth Bank is the national leader in HSA
banking. OptumHealth Bank offers the convenience
of banking through your health plan website,
www.myuhc.com.
Yes. The IRS limits how much you can deposit into
your HSA each year if you enroll in an HDHP option.
The 2013 limits are $3,250 for individual coverage
and $6,450 for family coverage. If you are 55 or
older, you can deposit an extra $1,000 during the
year. This is called a catch-up contribution.
How do I enroll in the OptumHealth
Bank HSA?
If you enroll in the HDHP, the CenturyLink Health
and Life Benefits website will prompt you to
decide whether you want to open an HSA through
OptumHealth Bank. You will then be able to
make an election for per-paycheck contributions
to your HSA. Automatic paycheck deductions
are only available for an HSA opened with
OptumHealth Bank.
If you elect the HDHP and enter an automatic
payroll contribution to the HSA, your information will
be sent to OptumHealth Bank to open your HSA.
You must have a physical address on file to open
an HSA account.
Do I have to pay federal taxes on the money
I deposit in an HSA?
No. You can contribute on an after-tax basis. When
you deposit money into an HSA, you won’t have to
pay federal income tax on:
Deposits
you or others make to your HSA
Money
you spend from your HSA on qualified
expenses
Interest
earned from the HSA
There are currently three states that require you
to pay state income tax on the HSA: Alabama,
California and New Jersey.
Can other people contribute to my HSA?
Yes, anyone can contribute to your HSA. A family
member, for example, may choose to give you
money that you can deposit into your account.
Wherever the money comes from, though, keep
in mind there are annual contribution limits set by
the IRS. Contributions above the annual limit are
subject to income taxes and a penalty.
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What happens to my HSA if I leave my
current employer, change medical plan
options or retire?
Any money deposited into your HSA is yours to
keep. If you leave the Company, change medical
plan options or retire, you can take your HSA
with you.
I want my HSA dollars to go as far as
possible. So how can I find out how much
a treatment or procedure is going to cost?
After you enroll, you will have tools on
www.myuhc.com like the myHealthcare Cost
Estimator to help you make the best decision
regarding your care. The myHealthcare Cost
Estimator can help estimate the cost of treatments
and other procedures based on your health plan,
a specific doctor or hospital, and your ZIP code.
If I need to pay for a doctor visit or for
a prescription, how do I do so using
HSA dollars?
When you have a visit with a network doctor, he or
she will submit the claim for you. UnitedHealthcare
will process the claim to:
Once you receive a bill from your doctor or if you
are at the pharmacy filling a prescription, you have
a few options.
First,
most banks will give you a debit card to
make paying easy. You can pay the bill with your
debit card by filling out the credit/debit card
information on the bill. If you are at the pharmacy
or a walk-in clinic, you can swipe the card or
hand it to the cashier, just like you would with
any other debit card.
Some
banks may also make checks available to
you (sometimes for a charge).
You
can pay another way, such as with cash
or other credit card. Later you can choose to
reimburse yourself from your HSA. Or, let your
dollars grow for the future.
Can I use the HSA for my spouse or
dependents if they are not covered under
my plan?
Yes. You can use the money in the HSA to pay
for qualified medical expenses of your spouse
and your dependents even if they are not covered
by your plan option.
Make
sure the claim is an eligible expense under
your plan option.
Determine
whether the claim was for eligible
preventive care, so it can be paid 100 percent,
which does not affect the HSA.
Make
sure the service is charged at a lower rate
by seeing a network doctor.
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If I am still carrying medical coverage for
my 24-year-old, can I use my HSA to help
pay for his qualified medical expenses?
An adult child must still be a tax dependent in
order for his or her medical expenses to qualify for
payment or reimbursement from a parent’s HSA.
If the adult child is not a tax dependent but is
covered by a parent’s HSA-eligible HDHP option,
he or she may be able to open his or her own HSA.
In these circumstances, it is best to consult with a
competent tax advisor.
What if my spouse is also covered by an
HSA-eligible health plan and has an HSA?
Federal law says that in this case, the two of you
together can only contribute up to the family limit.
If I’m 65 or older and decide to retire,
what happens to my HSA?
Once you retire, you can continue to receive tax
benefits when you use the HSA for qualified medical
expenses. If you are 65 years old or older, there is
no penalty for withdrawing your money, even if you
enroll in Medicare. When your Medicare coverage
starts, you can use your HSA to pay your Medicare
premiums, deductibles and copayments. After
you turn 65 or become entitled to Medicare
benefits, you may withdraw money from your
HSA for non-medical purposes without penalty.
The withdrawal is treated as retirement income
and is subject to normal income tax.
Can I have an HSA and a Healthcare Flexible
Spending Account or FSA?
No. If you are enrolled in a Healthcare FSA, federal
tax law does not permit you to be eligible for an
HSA. But the law does permit you to enroll in
what is called a limited-purpose FSA to pay for
eligible dental and vision expenses. CenturyLink
offers a Limited FSA for participants in the HDHP.
Review your Annual Enrollment materials for
more information.
Can I have a Dependent Day Care FSA if I set
up an HSA?
Yes, you may also open a Dependent Day Care FSA
that can help you save to pay for qualified day care
expenses for children under 13 or adult dependents
who cannot care for themselves.
Health4MeSM Mobile App
What is the Health4Me Mobile App?
Download our Health4Me Mobile App to your
smartphone or tablet and see how easy it is to find
nearby physicians, check the status of a claim, see
your account balance or speak directly with a nurse.
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Additional Questions
Where do I find more details on the CDHP?
You can find detailed plan information in the
CDHP Summary Plan Description (SPD) located
on the CenturyLink intranet under HRLink-HR/
Benefits or on www.centurylinkbenefits.com.
Who should I contact if I have questions
about other CenturyLink healthcare or life
insurance benefits?
Contact the CenturyLink Service Center toll-free at
(800) 729-7526. The toll-free number is available
from 8:30 a.m. to 6:30 p.m. Central time, M-F.
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Understanding Your
Prescription Drug Coverage
The following frequently asked questions will help
you understand how the United Healthcare (UHC)
prescription drug program works.
What is a Prescription Drug List (PDL)?
A PDL is a list that places commonly prescribed
medications for certain conditions into Tiers. The list
includes brand and generic prescription medications
approved by the U.S. Food and Drug Administration
(FDA). When choosing a medication, you and your
doctor should consult the PDL to help you get the
most out of your prescription medication benefit.
Please note that there may be some medications
on the PDL that are not covered under your
prescription medication benefit.
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What are Tiers?
Prescription medications are placed into Tiers. Each
Tier is assigned a cost, which is determined by the
employer or health plan. This is how much you will
pay when you fill a prescription. Tier 1 medications
are your lowest-cost option.
Why are brand name medications in Tier 1?
UHC may place certain brand name medications
into Tier 1 when they offer the best overall
healthcare value or, if no generics are available.
When do medications change Tiers?
Medications may change Tiers two times per
calendar year. Changes occur on January 1 and July
1. When a generic medication becomes available,
the Tier placement of both the brand and generic
medication are evaluated. Medications may change
Tiers with this evaluation.
When a medication changes Tiers, you may have
to pay a different amount for that medication. These
changes may occur without prior notice to you.
For the most current information on your pharmacy
coverage, please call the toll-free participant phone
number on the back of your health plan ID card or
visit www.myuhc.com.
1
Why is the medication that I am currently
taking no longer covered (Why were some
medications excluded from the PDL)?
Medications may be excluded from coverage
under your pharmacy beneﬁt. For example, a
medication may be excluded from coverage
when it is therapeutically equivalent to another
prescription medication or an over-the-counter
(OTC) medication. There may be alternatives on
the PDL or OTC medications that are right for
your treatment.
What are supply limits?
A supply limit is the largest quantity of a medication
covered per copayment1 or in a time period.2 Supply
limits are based on dosing guidelines included in
FDA labeling, dosing recommendations, medical
literature and on your benefit design.
How it works: If your current prescription is
more than the supply limit, you will have the
following options:
Either
pay the full cost or an extra copayment for
the additional supply.
Talk
to your doctor about the medication or
dosing alternatives.
Request
an override for the additional supply
(when available).
heck your SPD to determine whether you have a copayment, coinsurance or deductible. Medication amounts that are
C
more than the supply limit may not count toward your deductible.
2 On
average, one month is the time period for supply limits. Please check your benefit plan documents or SPD for your
benefit-specific time period.
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What is the ProgressionRx (step
therapy) program?
What is the Specialty Pharmacy Program?
ProgressionRx is UHC’s step therapy program.
How it works: With this program if a particular
drug requires step therapy, you need to try a Step
1 medication first, before a Step 2 medication may
be covered. If you bring a prescription for a Step
2 medication to the pharmacy, your claims history
is checked for a Step 1 medication. If you have
a recent claims history for a Step 1 medication,
the Step 2 medication will be processed. If not,
your doctor is contacted for a coverage review.
If it is determined with your doctor that a Step
1 medication has not been used in the past for
therapy, the Step 2 medication may not be covered.
But you may make a claim under the Plan’s claim
procedures to appeal this decision.
You get a
prescription
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Try a Step 1
medication first
Before a Step 2
medication may
be covered
Specialty medications are managed through
the Specialty Pharmacy Program. Take advantage
of personalized patient support designed to help
you get the most out of your treatment plan.
UHC’s Specialty Pharmacy Program also offers
on-call pharmacists available 24 hours a day,
robust clinical and adherence programs, coaching
on lower-cost medication options, and additional
resources and condition-specific support. Visit
www.uhcspecialtyrx.com or call (866) 429-8177
to learn more. Please note your specialty medication
may not be listed in the PDL since the PDL lists the
most commonly prescribed medications.
What pharmacies are in my retail network?
Choose a pharmacy that’s in your network. There
are more than 60,000 retail pharmacies in the UHC
Network, and include both chain and independent
stores located across the United States. Filling your
prescriptions outside the network of pharmacies
may cost more. To find a pharmacy, visit UHC’s
website at www.myuhc.com, or call the toll-free
participant phone number on the back of your ID
card and use the voice-activated pharmacy locator.
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What is the mail order program?
Why spend more money than you have to? You
won’t when you use the mail order pharmacy
instead of your current participating retail pharmacy
to fill long-term prescriptions. Saving money is just
the beginning. The mail order pharmacy provides
services to make your life a little easier by offering
these services: medication delivery right to you;
no charge for standard shipping; a three-month
supply of medication so you don’t have to refill
as often; 24/7 phone access to pharmacists with
specialized training; and www.myuhc.com, where
you can access the tools and information you need,
whenever you want.
Mandatory Mail Program
taking a maintenance medication, you may want
to order a 30-day supply at first. The mail order
program allows for this transition. The first two times
you purchase each maintenance medication at a
participating retail pharmacy, you will pay the retail
copayment. After that, you will pay a higher cost for
each maintenance medication at a retail pharmacy.
To learn more about your pharmacy benefit and
medications:
Visit www.myuhc.com, your best resource for
medication pricing and comparisons and coverage
information based on your benefit.
Call the toll-free participant phone number on the
back of your health plan ID card.
You will pay a higher cost for maintenance medications
if you continue to purchase them at a participating
retail pharmacy. However, if you use the mail order
service, you will pay the mail order copayment for
up to a 90-day supply. (You will be charged a mail
order copayment regardless of the number of days’
supply that is written on the prescription.)
Important Note About a Penalty: When you begin
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