Benefits Plan Overview

Pre-Tax Benefits

 Flexible Spending Accounts*

• Medical Reimbursement Maximum $2,750/year
• Dependent Care Reimbursement Maximum $5,000/year

 Cancer Benefits: Colonial Life

 Accident Benefits: Colonial Life

Medical Bridge Benefits: Colonial Life

Dental Insurance**: Delta

 Vision Insurance: UnitedHealthcare

* You will need to re-sign for the Spending Accounts if you want them to continue next year.

Post-Tax Benefits

 Disability Benefits: Colonial Life

 Critical Illness Benefits: Colonial Life

 Telemedicine: Call A Doctor Plus

Legal Select Plan: Legal Resources

 Life Insurance

• Term Life Insurance: Colonial Life
• Whole Life Insurance: Colonial Life

**EMPLOYEES WILL NEED TO RE-ENROLL IN VISION BENEFITS IN ORDER TO CONTINUE COVERAGE FOR THE NEW PLAN YEAR BEGINNING JANUARY 1, 2021.

Insurance Products will remain in effect unless you see a representative to change them.

Enrollment Period: October 13, 2020 – October 14, 2020

Effective Dates: January 1, 2021 – December 31, 2021

QUALIFICATIONS:

• Employees must work a minimum of 20 hours per week to participate in Flexible Spending Accounts, Colonial Insurance products, Telemedicine and Legal benefits.

• Employees must work a minimum of 30 hours per week to participate in Dental and Vision benefits.

IMPORTANT FACTS:

• The plan year for Colonial Insurance products, Spending Accounts, Delta Dental, Superior Vision, Call A Doctor Plus Telemedicine and Legal Resources Legal Select Plan lasts from January 1, 2021 through December 31, 2021.

• Deductions for Delta Dental and Superior Vision will begin December 2020. Deductions for Colonial Insurance products, Spending Accounts, Call A Doctor Plus Telemedicine and Legal Resources Legal Select Plan will begin January 2021.

• Health FSA Rollover Provision: Your employer provides the rollover option for your FSA plan. Please see the Flexible Spending Account section of your benefit booklet for more information on this provision.

• If signing up for any coverage on your spouse and/or children, please have their dates of birth and social security numbers available when meeting with the Benefits Representative.

• If you will be receiving a new debit card, whether you are a new participant or to replace your expired card, please be aware that it may take up to 30 days following your plan effective date for your card to arrive. Your card will be delivered by mail in a plain white envelope. During this time you may use manual claim forms for eligible expenses. Please note that your debit card is good through the expiration date printed on the card.

• Elections made during this enrollment period CANNOT BE CHANGED AFTER THE ENROLLMENT PERIOD unless there is a family status change as defined by the Internal Revenue Code. Examples of a family status change are: marriage, divorce, death of a spouse or child, birth or adoption of a child, termination or commencement of a spouse’s employment, or the transition of spouse’s employment from full-time to part-time, or vice-versa.

• Once a family status change has occurred, an employee has 30 days to notify the North Carolina Service Center at 1-888-662-7500 to request a change in elections.

• Medical Reimbursement and Dependent Care Reimbursement expenses must be incurred during the Plan Year in order to be eligible for reimbursement.

• An employee has 90 3days after the plan year ends to submit claims for medical reimbursement and/or dependent care expenses that were incurred during the plan year. Please note that if employment terminates during the plan year, that employee’s plan year ends the day employment ends. The employee has 90 days after the termination date to submit claims.

• With Dependent Care Flexible Spending Accounts, the maximum reimbursement you can request is equal to the current account balance in your Dependent Care account. You cannot be reimbursed more than has actually been deducted from your pay.

• The Colonial Cancer plan and the Health Screening Rider on the Colonial Accident and Colonial Medical Bridge plan have a 30-day waiting period for new enrollees. Coverage, therefore, will not begin until January 31, 2021.

• Additionally, some policies may include a pre-existing condition clause. Please read your policy carefully for full details.

• Please be aware there are certain coverages that may be subject to federal and state tax when premium is paid by pretax deduction or employee contribution.

• An employee taking a leave of absence, other than under the Family & Medical Leave Act, may not be eligible to re-enter the Flexible Benefits Program until the next plan year. Please contact your Benefit Administrator for more information.