Professional Documents
Culture Documents
Eligibility
Eligible Employees: Direct full time employees Eligible Dependents: Spouse: Legally married, or legally recognized common law (certified through the court system) if you reside in a state that recognizes common law. Children: Natural children, legally adopted, stepchildren, other children for whom you have legal guardianship (grandchildren, etc.) eligible up to age 26, regardless of marital or student status dependent children of any age who are unable to support themselves due to a disability
Both Employee and Spouse Work for Mustang: You may both elect employee only coverage or one may waive coverage and be covered as a dependent. Only one employee may elect coverage for dependent children.
Approved Leave of Absence: You may be entitled to continue your group health benefits if you make required employee contributions. Contact the Benefit Team for further information.
Our plan is subject to IRS regulations under our Cafeteria plan relative to QSCs.
Employee Contributions
January 1 through December 31, 2012
Weekly Premium
$41.31 $100.39 $85.15 $119.77
Bi-Weekly Premium
$82.62 200.77 $170.31 $239.54 $-0$43.38 $36.92 $55.38
Eyemed Vision
Employee Only Employee + Spouse Employee + Child(ren) Employee + Family $1.28 $2.40 $2.52 $3.88
Specialty Drugs(2)
(1)
$120 Copay
RRA (Retail Refill Allowance) applies to all maintenance drugs when not changed to the mail order program. After second re fill at retail pharmacy you will pay the corresponding Mail Order Co-pay for the 30 day prescription on the Traditional POS plan and will pay an additional 20% penalty on the Value High Deductible Health Plan.
(2)
Specialty Drugs must be purchased through Medco's specialty pharmacy, Accredo. NOTE: Value HDHP Family deductible must be met before claims are paid at 80% if you have family coverage.
PPO network
In-network = best benefit (network discounts) Out of Network = same benefit level no discounts Preventive Care 100% Basic Services 80% after Deductible Major Services 50% after Deductible Orthodontics 50% after Deductible (children to age 20) $50.00 individual up to $150.00 family deductible $1,500 per person annual maximum benefit $1,500 per child lifetime maximum benefit on orthodontics No prior coverage requirement for major or orthodontia benefits
**** Please make sure you have a DHMO provider in your area, PRIOR to electing this plan ****
Up to $63
Lenses (every 12 months) Single vision Bifocals Trifocals Standard Progressive Lens Options Standard Polycarbonate Standard Plastic Scratch Coating Tint UV Treatment Standard Anti-Reflective Coating Other Lens Options Contact Lenses (every 12 months) In Lieu of Glasses Conventional Disposable
$0 $0 $0 $65 Copay
$40 Copay $0 $15 Copay $15 Copay $45 Copay 80% of Charge
Up to $8
Up to $100 Up to $100
Tax-advantaged program to pay for qualified out-of-pocket healthcare expenses. You must be enrolled the AetnaValue HDHP. IRS Regulations state that you are not eligible to contribute to an HSA if you are enrolled in any other non-HDHP plan, including group plan with spouse, individual plans, Medicare and Medicaid plans. Maximum 2012 calendar year contributions : $3,100 individual contribution (if single coverage is elected) $6,250 family contribution (if dependent coverage is elected). $1,000 catch-up contribution if you are age 55 or older in 2012 Withdrawals are tax-free if used for qualified healthcare (medical, dental, vision) expenses. OTC medications are no longer eligible unless you have a written prescription from your physician. Funds not used within the calendar year roll over and continue to grow and are fully portable. Debit card will be issued; checks available upon request.
Funds are available as deducted each pay period and deposited into your HSA account.
May make changes to contributions during the year.
If enrolled in the Health Savings Account You will be eligible to elect the Limited FSA for reimbursement of qualified dental and vision out-of-pocket expenses only.
Dependent Day Care FSA funds are available as deducted each pay period and deposited to your account.
Funds not used by the end of the calendar year will be forfeited. BE CONSERVATIVE!
Participants (if not in HSA) will receive a Prescription debit card for use at retail pharmacy and mail order . A full debit card is not available. Aetna offers Streamlining which reimburses you automatically from FSA account once a claim is processed, for your out-of-pocket amount. (copayments, deductible and coinsurance) You may opt out of Streamlining and file FSA claims directly with Aetna.
EMPLOYER-PROVIDED LIFE & AD&D INSURANCE BENEFITS 1 times your base pay up to a maximum of $150,000 Life amounts reduce by 35% at age 65 and by 50% at age 70
EMPLOYER-PROVIDED SALARY CONTINUATION IF DISABLED (processed through payroll) 60% of your average weekly salary up to a maximum of $300/week 7 calendar day elimination period Maximum payment duration up to 12 weeks of disability (6 weeks postpartum for maternity) Salary continuation is subject to income tax and current benefit deductions
VOLUNTARY STD BENEFITS 60% of your average weekly salary up to a maximum of $1500/week 7 calendar day elimination period Maximum payment duration up to 12 weeks of disability (6 weeks postpartum for maternity) Guarantee issue if you apply when first eligible; subject to evidence of insurability if you elect during subsequent open enrollments.
$300,000
$25,000
$10,000
Up to a maximum of $500,000
Up to $10,000
NOTE: -
If you and your spouse are both direct employees of Mustang, you may each elect voluntary employee life for yourself. Only one of you can elect child life coverage for your child(ren). Life and AD&D benefit reduces by 35% at age 65 and 50% at age 70. Hartford will cover unmarried dependent children to age 26 without being a full time student.
Long Term Care provides benefits when someone needs help with at least 2 out of the 6 Activities of Daily Living: bathing, dressing, toileting, transferring, continence, eating - or someone who has suffered a severe cognitive impairment. Care could be provided in the home, in an assisted living or residential care facility, or in a skilled nursing facility such as a nursing home. Rates are approximately 30% less than their comparable individual policy. You can purchase coverage for yourself or your spouse. Coverage is also available for purchase by your children, siblings, parents, mother and father-in-law and grandparents. Evidence of Insurability required on all participants. Contact the HR Benefit team for a detailed packet of information and enrollment forms.
Mustang provides Business Travel Accident (BTA) coverage at no cost to employees. The plan covers accidents and injuries that occur while traveling on business for Mustang. Coverage includes:
$100,000 Accidental Death & Dismemberment (AD&D) for employee $25,000 Accidental Death & Dismemberment for spouse on approved travel with the employee Emergency Medical Benefit up to $10,000 Emergency Medical Evacuation Benefit
For more details on this coverage you can access the Summary Plan Description on MyMustang/HR Benefits/BTA section.
Co-payments at the Take Care Health Center do not apply to medical plan deductibles or out-ofpocket expenses. May use your HSA debit card to pay for services.
What are some of the legal matters covered by the plan? Unlimited attorney phone consultations Simple wills, living wills, living trusts, medical power of attorney Divorce Bankruptcy, debt collections defense Civil litigation defense Identity theft assistance Real estate closing/refinancing/foreclosures Driving violation defense Tax audits
Limitations on pre-existing legal matters.
Available to you and members of your household. Enrollment in the Aetna medical plan not required to use EAP benefits. Each individual eligible for EAP benefits has up to 5 visits per issue per year with a trained professional for assistance with emotional, interpersonal, financial, legal and/or substance abuse issues. Visits must be authorized by Aetna Behavioral Health. Concierge services through work/life partner, LifeCare, such as assistance with airline arrangements, location of home improvement contractors, grocery deliveries, pet walkers and sitters, personal shoppers, etc.
Offers a comprehensive collection of programs, discounts, resources, and educational tools to help you and you family become healthier, safer and more productive
All employees can take advantage of: The Simple Steps To A Healthier Life online health and wellness program The Employee Assistance Program (EAP), for help with personal and work life issues
If you are enrolled in an Aetna medical plan, you have access to: Aetna Navigator , your secure member Web Site Aetna Health ConnectionsSM for help managing chronic conditions Informed Health Line, a 24-hour, toll-free health information phone line Personal Health Record, an online record of claims-based medical information Beginning Right maternity management program Discounts on health-related products and services
Websites to Know
Aetna - Medical and Dental Plans www.aetna.com Provider search, claim details, FSA and HSA account information Traditional POS & Value HDHP Medical Plans Network: Aetna Choice POS II (Open Access) Dental Plan Networks: PPO (Indemnity) : Dental PPO/PDN with PPOII Network DHMO: Dental Maintenance Organization Medco Prescription Drug Plan www.medco.com Mail Order Online, pricing medications, alternatives to brand name drugs, claim history Eyemed Vision www.eyemedvisioncare.com Network - Access Provider lists and plan eligibility The Hartford Life Insurance and Will Preparation
Concierge funeral planning, beneficiary assistance, estate planning tools, legal assistance,-www.hartfordlifeconversations.com Estate Guidance service to create a simple legal Will online, step-by-step instructions www.estateguidance.com/wills (Promotional CODE: WILLHLF) EAP Aetna www.aetnaeap.com
Login: MYWDGEAP / Group # 889013 Personal counseling, financial guidance assistance, legal assistance for home buying, divorce, debt management. Beneplace-Discount Website- www.beneplace.com/woodgroup Discounts on automobile/homeownders insurance, electronics, entertainment venues, etc.
On-Line Enrollment
New Hire Enrollment Kits will be mailed to your home. Includes website information and your user name and password. Easy online enrollment instructions www.ebenefitsolutions.com/woodgroup.htm It is recommended that your election decisions are made BEFORE going on line. Knowing your options before enrolling will make your online experience as easy as 1, 2, 3! All detailed benefit plan documents can be reviewed on MyMustang/HR Houston/Benefits.
IMPORTANT REMINDER: Social Security Numbers were required by Centers for Medicare for all enrolled participants on health plans as of January 1, 2010. If any enrolled dependents do not have SSNs, claims could be delayed and/or denied until they are provided.
For Technical Support for online enrollment website issues call Woodgroup Benefit Service Center: 1-866-449-9663 - 8:00 a.m. 5:00 p.m. CST, Monday through Friday What is my password? My password does not work. I am having problems with the enrollment site. Call to enroll rather then enrolling online.
Contact one of your HR Benefits Team Members for benefit and plan questions and for returning forms (Life Insurance and Chase Bank Beneficiary forms)
BEST option to reach the Benefit Team, Email: Benefitsgroup@mustangeng.com
Or
~ Linda Cummins - Benefits Manager : linda.cummins@mustangeng.com PH: 713-215-8179 FAX: 281-646-3179 ~ Jill Bromley - Benefits Specialist: jill.bromley@mustangeng.com PH: 281-206-6202 FAX: 281-206-1202