Benefits Plan Overview

Pre-Tax Benefits

Dental Insurance: Blue Cross Blue Shield

Vision Insurance: Superior Vision

Cancer Benefits: Colonial Life

Accident Benefits: Colonial Life

Medical Bridge Benefits: Colonial Life

Post-Tax Benefits

Disability Benefits: Colonial Life

Critical Illness Benefits: Colonial Life

Life Insurance: Colonial Life
– Term Life Insurance
– Whole Life Insurance

Telemedicine Benefits: Call A Doctor Plus (Direct Billing Only)

Additional Benefits

Student Loan Assistance Program: GradFin

Employee Assistance Program: NexGen (Employer-Paid Benefit!)

Please note your insurance products will remain in effect unless you speak with a representative to change them.

Enrollment Period: JULY 25, 2023 – JULY 26, 2023

Effective Dates: AUGUST 1, 2023 – JULY 31, 2024

QUALIFICATIONS:

– Employee must work 30 hours or more per week.

IMPORTANT NOTICES:

– When do my benefits start? The plan year for Colonial Insurance products, BlueCross BlueShield Dental and Superior Vision runs from
August 1, 2023 through July 31, 2024.

– When do my deductions start? Deductions for Colonial Insurance products, BlueCross BlueShield Dental and Superior Vision will begin August 2023. The Call A Doctor Plus Telemedicine plan is available by Direct Billing only. No deductions will be taken via payroll deduction.

– Why have my Cancer, Accident, or Medical Bridge benefits not started yet? 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 August 31, 2023.

– What is an EAP? Your employer offers an Employee Assistance Program (EAP) for you and your eligible family members. An EAP is an employer-sponsored benefit that offers confidential support and resources for personal or work-related challenges and concerns. Please see the EAP pages of this benefit guide for more details and contact information.

– I want to sign my family up for benefits as well, what information will I need? If signing up for any coverage on your spouse and/or children, please have their dates of birth and social security numbers available when speaking with the Benefits Representative. What is the difference between pre and post-tax benefits? Pre-tax benefit contributions are taken from an employee’s paycheck before state and federal taxes are applied. Post-tax benefit contributions are paid after taxes are deducted. It’s important to note that some coverages may still be subject to taxes even if paid for through pre-tax deduction or employee contribution.

– Can I change my benefit elections outside of the enrollment period? Elections made during this enrollment period CANNOT BE CHANGED AFTER THE ENROLLMENT PERIOD unless there is a family status change, otherwise known as a qualifying life event (QLE), as defined by the Internal Revenue Code. Examples of a QLE can be found in the chart in your Benefits Guide. Once a QLE has occurred, an employee has 30 days to notify PGB’s Service Center at 1-888-662-7500 to request a change in elections.

– I have a pre-existing condition. Will I still be covered? Some policies may include a pre-existing condition clause. Please read your policy carefully for full details.

IMPORTANT NOTICES REGARDING DENTAL PLAN WAITING PERIODS:

Enrolling In This Dental Benefit Plan

– You are a timely enrollee if you apply for coverage and/or add dependents within a 30-day period of when you first become eligible for
coverage under this dental benefit plan or within 30 days following a qualifying event as described below. Once dental coverage has
terminated, regardless of the reason, you may not re-enroll, unless a qualifying event occurs.

– If you apply for coverage at a time, which does not qualify you or your dependents as timely enrollees as stated above, then you are
considered late enrollees. Late enrollees have no waiting period for diagnostic and preventive services. For all other dental services, where
timely enrollees have no waiting period, late enrollees have a 12-month waiting period. Where timely enrollees have waiting periods, these
waiting periods are doubled for late enrollees. See “Waiting Periods.”

Waiting Periods

– There is no waiting period for members to receive benefits for diagnostic and preventive, or basic services, except for late enrollees.
However, there is a 12-month waiting period for major services and a 12-month waiting period for orthodontic services. These waiting periods are doubled for late enrollees. Eligible children who are added as a result of a court order are not subject to a waiting period. Waiting periods are waived for timely enrollees who can show proof of prior dental coverage, with a maximum gap in coverage of no more than 63 days. If a waiting period applies, see the Dental Coverage chart in “Covered Services.”