View Contents - My Benefit Statement

Your Total
Compensation
Statement
Setting Us Apart
From The Competition
Contact Information:
Benefit Plan Enrollment:
www. Smartben.com
Employee Self-Service:
https://portal.adp.com/public/index.htm
Hub\Human Resources
Hub\Wellness
Health Insurance:
Community Blue PPO, Traditional, DenteMax and VSP
Email: [email protected]
Note: Be sure to include your contract number (off of
your insurance card) as well as your group number in all
communications.
BCN
Ombudsman’s Office: 1-888-265-4703
Web sites:
www.bcbsm.com
www.dentemax.com
www.vsp.com
Address
Mail Code X-310
600 Lafayette East
Dept. 1703
Detroit, MI 48226
Accident Fund Group #:
38110
Prescription Refill Center:
1-800-651-0155
Medco Member Services:
1-800-903-8346
Dental Services:
1-877-258-0167
Other Helpful Numbers:
BCBSM Mail Code: B-183
Emergency/Weather hotline: 1-888-WORK4AF
RITE Call: 1-800-852-8757
ADP Cobra Services: 1-800-526-2720
BCBSM Retirement Administration:
[email protected] or 1-800- 922-0699 or
(313) 225-9609
Employee Assistance Program:
EAP Consultants - 1-800-869-0276 or www.eapconsultants.com
Fidelity Investments: 1-800-378-4015 or www.401k.com
Flexible Spending Accounts:
1-800-654-6695 or www.flexdirect.adp.com
Group Universal Life Insurance Company:
Marsh@WorkSolutions - 1-800-621-2358
Group Life Insurance Company: Reliastar - 1-800-955-7736
IncentaHealth: http://accidentfund.incentahealth.com
Long-Term Disability: 1-800-707-2288
Service Awards:
OC Tanner 1-800-453-7490 or
http://www.eawardcenter.com/rb/0000101591/8
Short-Term Disability/Integrated Disability Management:
Lana McDowell, R.N. – (517) 367-6370 or
[email protected]
your total compensation statement
2010
Your Total Compensation
2010 Benefit Plans
January 2009 – December 2009
Accident Fund
Contribution
Category
Direct Pay
Regular Pay
Annual/School Leave
Sick Leave
Personal Leave
Holiday Leave
Overtime
Incentive Pay
Other Pay 1
Total Direct Pay
Required Benefits
Social Security Taxes
Medicare
Unemployment
Workers’ Compensation
Health Benefits
Medical and Prescription
Dental
Vision
Employee Assistance Program
Life and Disability Benefits
Basic Life and AD&D
Long-Term Disability
Retirement Benefits
401(k) Plan
Pension Plan 2
Health Promotion Benefits
Fund Advantage
Health Promotion/Wellness 3
Additional Benefits
Parking
Your Total Compensation
Your
Contribution
$35,029.71
$3,279.30
$1,413.03
$308.64
$1,697.52
$29.16
$773.98
$3,000.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$45,531.34
$0.00
$2,871.67
$671.60
$344.00
$136.42
$2,871.67
$671.60
$0.00
$0.00
$13,088.64
$1,407.24
$261.84
$26.04
$0.00
$0.00
$0.00
$0.00
$278.40
$228.43
$0.00
$100.36
$517.78
$3,517.38
$1,035.52
$0.00
$750.00
$115.00
$0.00
$0.00
$1,344.00
$0.00
$71,089.78
Other Pay includes one or more of the following pay categories: Bereavement, Birthday, Court, Jury, Mileage, Military,
On Call, Relocation, SRA, STD, and Vehicle Stipend.
The pension plan amount represents the average employer cost of pension benefits for 2009 applied to your base pay.
3
The Wellness program amount Includes average cost per employee for all e-Balance programming and incentives.
2
A Picture is Worth a Thousand Words
This chart illustrates your total compensation package
63%
23%
DIRECT PAY
RETIREMENT & OTHER
Health Care Plans
Medical and Prescription Insurance
Accident Fund offers a choice of three medical plans: Community Blue PPO, Blue
Care Network HMO and Healthy Blue Living HMO. Our records show you have
EE + Family coverage in the following medical plan.
Community Blue PPO
Your In-Network Cost
Deductible
Preventive Care Services
Office Visits & Urgent Care
Emergency Room
Inpatient Hospital Care
Prescription Retail (30 days)
Prescription Mail Order (90 days)
$250 per member, $500 per family
Covered at 100% - one per calendar year
$10 copay
$50 copay for facility; 100% for ER professional fees
Covered at 100% after deductible
Copay: $7 generic, $15 formulary, $30 non-formulary
Copay: $14 generic, $30 formulary, $60 non-formulary
Dental Insurance
Accident Fund offers a choice of two Dental plans: Exclusive Dental Plan and
Traditional Plus Plan. Our records show you have EE + Family coverage in the
following dental plan.
Traditional Plus Plan
Your Cost
Preventive Services
Diagnostic Services
Restorative Services & Adjunctive Procedures
Oral Surgery, Periodontics & Endodontics
Prosthondontics
Orthodontic Services
Annual Maximum (calendar year)
Covered at 100%
Covered at 100%
Covered at 75%
Covered at 75%
Covered at 50%
Covered at 50%; lifetime max of $2,400
$2,300 per member
Vision Insurance
Accident Fund offers the Blue Vision (VSP) and the Blue Traditional vision plans.
Our records show you have EE + Family coverage in the following vision plan.
VSP Vision
Eye Exam
Eyeglasses
Contact Lenses
(medically necessary)
In-Network
$5 copay
$7.50 copay, maximum $150
$7.50 copay
HEALTH, LIFE & DISABILITY
REQUIRED
Employees may pay for health and/or dependent care expenses with pre-tax
dollars, which will be payroll deducted for your convenience. The annual
maximum for each account is $5,000.
Health Care Flex Spending Account
You have not elected to contribute to the Health Care Flex Spending Account.
Dependent Day Care Flex Spending Account
Out-of-Network Provider
Reimbursed up to $35 less $5 copay
$7.50 copay, up to predetermined amt
Reimbursed up to $210 after $7.50 copay
Premium Only Plan (POP)
6%
8%
The following information reflects your 2010 benefit elections including highlights of
the plans in which you are enrolled. For more information about a specific benefit
plan, please refer to the benefit descriptions on the Human Resources website.
Questions about your individual coverage may be directed to Human Resources or
the appropriate insurance carrier. All contact information is listed on the inside front
cover of this statement.
$4,679.15
Note: The information above is based on data as of 12/31/2009 and may not reflect mid-year changes to plan
type or contributions.
1
Flexible Spending Accounts (FSAs)
POP allows employees to deduct medical insurance premiums for their paycheck pretax. Cost savings are achieved because Social Security and federal and state income
taxes are not applied to the premium deductions.
You have elected to contribute $2,500 annually to the Dependent Care Flex
Spending Account.
Life and Disability Benefits
Life and AD&D Insurance
Accident Fund provides basic life insurance equal to two times your annual base
salary and also occupational accidental death and dismemberment (AD&D)
insurance. Accident Fund pays 100% of the cost of this benefit. Our records
show you have $80,000.00 of basic life and $100,000.00 AD&D coverage.
Group Travel Accident Plan
Group Travel Accident insurance is provided by Blue Cross Blue Shield of
Michigan. This plan provides coverage for you in the event you die or lose a hand,
foot and/or eyesight as a result of an accident while traveling on company business
as an employee of Accident Fund.
Short-Term Disability (STD)
Short-term disability works in conjunction with Accident Fund's leave programs.
After fifteen consecutive days of a qualifying disability, short-term disability benefits
take effect, paying 66 2/3% of base salary for up to 90 days.
Long-Term Disability (LTD)
Accident Fund offers a company-paid LTD plan that provides a benefit equal to
66 2/3% of your gross income after 90 days of disability. All insurance premiums,
including medical and dental, will also continue to be paid for the first three
months on LTD.
your total compensation statement
2010
Retirement Benefits
Health Promotion Benefits
Long-term planning is a critical part of your financial security. Accident Fund offers two
retirement plans (in addition to Social Security benefits) to help you achieve financial
security in your retirement years.
eBalance
Presenting Your 2009
Total Compensation Statement
Our enterprise wide eBalance program provides comprehensive wellness and health
promotion programs that address all areas of health.
To: Harry Hardworker
401(k) Savings Plan
Employee Assistance Program (EAP)
Employees are eligible to participate in the company’s 401(k) plan through Fidelity
Investments after completing three months of service. Contributions are allowed
between 1% and 96.5% (in half percent increments) of your bi-weekly base
compensation on a pre-tax basis. Employees who are 50 years of age or older are
also eligible to make catchup contributions. After one year of service, Accident Fund
will make contributions equal to 50% of the amount contributed, up to 10% of your
base bi-weekly compensation. The maximum the company matches is 5%. All
contributions are subject to IRS limits. In 2010 the maximum electives deferred is
$16,500 and the maximum catchup contribution for those age 50 and older is $5,500.
Your employee contribution as of January 1, 2010, is 6.0%.
Accident Fund’s EAP provider is EAP Consultants. They offer assessment, shortterm counseling, and referral services for a wide range of personal problems, as well
as a variety of work/life issues. This benefit is 100% paid by Accident Fund.
Pension - Retirement Income Plan
Accident Fund provides a fully company paid retirement account plan. All represented
employees over 21 years of age, hired prior to January 1, 2010, with one year of
service begin earning service credits as of their hire date. Vesting ocurs after five years
of credited service or at age 65 regardless of number of years of service. In 2010, the
multiplier for the minimum benefit factor is $38 per month. To learn more about your
individual benefits under this plan, go to https://bcbsmi.pensionpath.com.
Fund Advantage
This cafeteria-style, miscellaneous benefit plan reimburses employees for eligible
expenses. Fund Advantage offers employees up to $500 annually after one year of
service, $750 after ten years of service, or $1,000 after 20 years of service are
completed. Reimbursements are issued with payroll checks and are taxable income.
Eligible expenses include:
 Fitness membership & equipment
 Computer Packages
 Weight loss programs
 Dependent Care
 Supplemental Health Insurance
 Additional Employee Tuition
 Supplemental Life Insurance
 Dependent Tuition
Additional Benefits
Social Security
L-HOPE
Both you and Accident Fund contribute a percentage of your earnings to Social
Security. For more information call 1.800.772.1213 or visit www.ssa.gov.
L-HOPE is designed to encourage Lansing area employees to buy a home in the
community where they work. This program annually provides up to five eligible
employees with a loan to be used for costs associated with purchasing either a home
or rental property in Lansing. L-HOPE loans are offered on a first-come first-served
basis to employees who do not currently own a home in the Lansing city limits.
Paid Time Off
Annual Leave
Paid Parking
Annual leave is be used to cover absences for vacation and necessary personal
business. The number of annual leave hours you accrue per 80 hours of paid
service depends on your total service credit. Annual leave accumulation is capped
based on years of service.
Employees who work in the Lansing offices receive 100% company paid parking.
Sick Leave
Sick leave may be used to cover medical appointments, illness, injury or disability.
You earn four hours of sick leave each bi-weekly pay period in which eighty hours of
service is completed.
Holiday Leave
You receive 11 holidays each year: New Year’s Day, Martin Luther King Day, Good
Friday, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Day after
Thanksgiving, Christmas Eve, Christmas and a Christmas Floating Day. Additionally,
in years when Independence Day falls on a Tuesday or Thursday, the Monday
before or the Friday after the holiday is also granted as a paid holiday.
RITE Call
High standards are more than a slogan or catch phrase, they are a way of doing
business. Maintaining high standards of Respect, Integrity, Truth and Ethics are key
components when building a reputation for trust and excellence. Accident Fund’s
RITE Call program offers a hotline at 1-877-852-8757, which is available 24 hours a
day / 7 days a week when all other internal avenues have been explored.
Tuition Assistance
Accident Fund offers a generous tuition assistance program as a benefit to help our
employees attain their educational goals. This benefit covers 100% of all qualifying
tuition, tests, fees, books and other required expenses up to an annual tuition limit.
For an undergraduate degree, the limit is $5,000 annually. For employees pursuing a
graduate level degree, the limit is $5,500 annually (up to $5,250 is available tax-free).
Birthday Holiday
Employees with 15 or more years of service are eligible to receive their birthday off
with pay.
Additional Leave
Employees are also entitled to paid time off for Bereavement Leave, Jury Duty, and
Military Leave.
Harry Hardworker - 100-630
We are pleased to present you with your personal 2009 Total Compensation
Statement. It is designed to help you understand the full value of your annual
compensation and benefits.
Pay is an important part of our compensation strategy, but it is only one part.
Your total compensation package includes your base salary, annual incentive
award, health and welfare benefits, retirement benefits, health
promotion/wellness benefits and other benefits.
As you review the value of your 2009 total compensation package, you will also
find information about the 2010 benefit plans in which you participate, as well
as optional coverage that is available to you.
Please review your Total Compensation statement carefully and keep it for
reference, just as you keep your other important documents. If you should have
any questions about your statement, please call your Human Resources office.
We appreciate all you do to contribute to the success of the company. Thank
you for helping to make Accident Fund and United Heartland great places to
work!
Sincerely,
Darcy Kerr,
Vice President, Human Resources
Other Benefits:
AFLAC (Accident Fund Only)
Alternative Work Schedules
Community Involvement
Life Secure Long Term Care Insurance (Accident Fund Only)
Service Recognition
Supplemental Life Insurance
Training Programs
Voluntary AD&D Insurance
Wellness:
As an enterprise we understand that our employees are our greatest asset, and that
their health is important. To ensure our employees have the opportunity to be healthy
our internal health promotion program, eBalance, takes a comprehensive approach
to address health and well being. The ultimate goal is an improved quality of life for
employees.
eBalance is committed to establishing an environment that supports a healthy
lifestyle. We provide programs that address total health. An example of the offerings
provided:
• incentaHEALTH (exercise, nutrition, motivation/support)
• Onsite education and exercise classes
• Financial assistance for health related products
• Employee Assistance Program
To take advantage of the many health promotion benefits you will want to enroll in
the incentaHEALTH program, as this is the portal for all eBalance programs.
About this statement
This statement is based on information made available from Accident Fund/United Heartland’s records, summary plan
descriptions, policy manuals, and other sources of data. All information is as of December 31, 2009 unless otherwise noted.
All insurance rates and elections are as of January 1, 2010. The preparation and distribution of this statement is not deemed a
guarantee of continued employment for any period.
While every effort has been made to report information accurately, all details furnished, including eligibility for benefits, must
be governed by the provisions of the plan documents. Please bring any errors to the attention of the Human Resources
department.
The benefits descriptions in this statement are provided for information purposes only. Nothing in this statement should be read
or interpreted to guarantee you any benefits for a specific period of time. Accident Fund/United Heartland reserves the right to
change or eliminate any of these benefits in its sole discretion to the extent allowed by applicable law.
Prepared Exclusively For
Harry Hardworker
123 This Street
Thattown, US 99999