2023 - Hanzo-Duomo - Benefit Guide Flipbook PDF

2023 - Hanzo-Duomo - Benefit Guide

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YOUR 2023 EMPLOYEE BENEFITS Effective January 1, 2023 - December 31, 2023

Welcome to Hanzo Nation!

Enrollment for 2023

Here at Hattori Hanzo Shears, we are committed to providing our employees with a benefits program that is both comprehensive and competitive. Our employees are our greatest asset. We want to make sure you use your health benefits as often as necessary and with as little difficulty as possible to keepwell. We invite you to review this brochure and familiarize yourself with the benefits available to you as a valued team member of Hattori Hanzo Shears. This brochure is intended to be a summary of the benefit plans we offer which are, of course, subject to change. Please login to your Employee Navigator Portal for your specific premiums.

Please note that our open enrollment usually runs during November each year. During this time, you can make changes to your benefits and add or drop dependent(s) from your medical, dental and vision plans. All changes being made during open enrollment will become effective on January 1st, 2023. Newly Hired Employee elections will be effective the first of the month following 60 days after your date of hire. If you do not enroll at that time, your next opportunity for enrollment will be during our annual Open Enrollment period. After you enroll in the benefit plans, you cannot change your elections until the next benefits enrollment period unless you have a qualifying event during the year. Examples of qualifying events include marriage, legal separation, divorce, birth or adoption of a dependent child, death of a spouse or child, change in employment status or a loss of other group benefit coverage. To make changes to your benefit elections, you must contact the Human Resources Department within 30 days of a qualifying event.

Medical Insurance

Hattori Hanzo Shears partners with United Healthcare and Kaiser to offer comprehensive medical plans to our employees and their families.

United Healthcare CI8L PPO

United Healthcare CJKO PPO

United Healthcare CQJK PPO HSA-Compatible

Annual Deductible (Individual/Family)

$1,500 / $3,000

$2,000 / $4,000

$5,000 / $10,000

Out-of-Pocket Max (Individual/Family)

$5,000 / $10,000

$7,150 / $14,300

$6,500 / $13,000

No charge

No charge

No charge

$25 / $50

$35 / $70

30% after deductible

30%

20% after deductible

30% after deductible

Imaging (CT, PET, or MRI)

30% after deductible

20% after deductible

30% after deductible (50% after deductible at hospital)

Hospital Inpatient (Facility Fee)

30% after deductible

20% after deductible

30% after deductible

Outpatient Surgery (Facility Fee)

30% after deductible

20% after deductible

30% after deductible

$50

$50

30% after deductible

Emergency Room

30% after deductible

20% after deductible

30% after deductible

Prescription Drugs

None

None

Medical Deductible Applies

Tier 1/Generic:

$10

$10

$10 after deductible

Tier 2/ Brand:

$45

$45

$35 after deductible

Tier 3/Non-Preferred:

$95

$95

$70 after deductible

Tier 4/Specialty:

$95

$95

$70 after deductible

In-Network Benefits Illustrated

Preventive Care Office Visit (PCP/Specialist) Diagnostic Test, Lab or X-ray

Urgent Care

Please login to your Employee Navigator Portal for your specific premiums.

Health Savings Account (HSA) If you enroll in one of the HSA-Compatible medical plans offered by Hattori Hanzo Shears, you are eligible to open your own Health Savings Account (HSA). This account was created by the federal government to provide a tax-advantaged way to save for medical expenses. Funds you deposit into your HSA while eligible are not taxed on the federal level. If you leave the company, your HSA will remain with you and you will be able to access any funds left in your account. The funds roll over year after year. Important Note: You are not allowed to contribute towards an HSA if you are also covered under a nonqualified health plan. This means that if you are also enrolled in a spouse's plan, Medicare, Medicaid or other programs like TRICARE, you are not eligible to contribute. 2023 Annual HSA Contribution Limits: $3,850 individual / $7,750 family

Catch-Up Contribution if Over Age 55: Additional $1,000

Find a Doctor United Healthcare PPO For CA residence, use Select Plus network: www.whyuhc.com/selectpluswest/search-for-a-provider For Non-CA residence, use Choice Plus network: www.whyuhc.com/choiceplus/search-for-a-provider Kaiser Permanente HMO CA Only Kaiser network: www.kp.org/findadoctor

Kaiser – CA ONLY Deductible HMO (High Plan)

Kaiser – CA ONLY Deductible HMO (Low Plan) HSA-Compatible

Annual Deductible (Individual/Family)

$1,500 / $3,000

$4,500 / $9,000

Out-of-Pocket Max (Individual/Family)

$4,000 / $8,000

$6,500 / $13,000

No charge

No charge

$40 / $50

40% after deductible

$15 after deductible

40% after deductible

30% up to $150 after deductible

40% after deductible

Hospital Inpatient (Facility Fee)

30% after deductible

40% after deductible

Outpatient Surgery (Facility Fee)

30% after deductible

40% after deductible

$40

40% after deductible

Emergency Room

30% after deductible

40% after deductible

Prescription Drugs

None

Medical Deductible Applies

Tier 1/Generic:

$10

30% up to $50 after deductible

Tier 2/ Brand:

$30

40% up to $100 after deductible

Tier 3/Non-Preferred:

$30

40% up to $100 after deductible

In-Network Benefits Illustrated

Preventive Care Office Visit (PCP/Specialist) Diagnostic Test, Lab or X-ray Imaging (CT, PET, or MRI)

Urgent Care

Tier 4/Specialty:

20% up to $250/script

Please login to your Employee Navigator Portal for your specific premiums.

40% up to $250 after deductible

Dental Insurance

In a continuing effort to promote good oral health, Hattori Hanzo Shears offers quality dental coverage through Principal.

Vision Insurance Hattori Hanzo Shears has partnered with Principal to offer a comprehensive vision plan.

Principal Dental PPO In-Network Benefits Illustrated

High PPO Plan Option

DEDUCTIBLE Single Family Deductible Waived For Preventive

$50 $150

$50 $150

Yes

Yes

BENEFITS Preventive Services

100%

100%

Basic Services

80%

80%

Major Services Orthodontia Services

50% 50%

50% Not Covered

PLAN MAXIMUMS Annual Maximum

$2,000

$1,000

(Includes Rollover)

(Includes Rollover)

$2,000

Not Applicable

Orthodontia Lifetime Maximum

Principal Vision PPO (VSP Choice Network)

Low PPO Plan Option

Find a Dentist 1. Visit www.principal.com/find-dentist 2. Enter ZIP Code, 3. Select ‘Principal POS Plan’ network For CA residence, EPO providers are available at discounted rates, otherwise all PPO providers will be in-network. Please login to your Employee Navigator Portal for your specific premiums.

In-Network

Non-Network

No charge $25

Amount over $45 Varies

COPAYMENTS Exam Copay Materials Copay

BENEFITS Exams

Every 12 Months

Lenses

Every 12 Months

Frames Contacts

Every 24 Months Every 12 Months

ALLOWANCES Lenses Single Vision Bifocal Trifocal Frames

Materials copay Materials copay Materials copay

Amount over $30 Amount over $50 Amount over $65

20% of amount over $150

Amount over $70

Amount over $150

Amount over $105

Contacts Elective

Find a Vision Doctor 1. 2. 3.

Visit www.vsp.com Select ‘Find a Doctor’ Enter location and Search Choice network

Employee Assistance Program (EAP)

Life and AD&D Insurance Hattori Hanzo Shears offers 100% company paid Basic Life and Accidental Death & Dismemberment (AD&D) Insurance to each eligible employee through Guardian for $20,000. Please note, benefits reduce by the following percentages by age - 35% at age 70 and 55% at age 75. If you leave Hattori, you can port or convert your life insurance to an individual policy within the first 30 days of your departure.

Colonial Life Voluntary Benefits

Employee Assistance Program (EAP) is available 24/7 through the Principal Magellan Healthcare program for all employees at no cost. The following confidential services are available. • 3 Face to Face Counseling Sessions • Completely confidential • Unlimited telephonic consulting with a counselor o 800.450.1327 • Work Life Resources • Legal Resources • Financial Resources • Lifestyle & Fitness Management • Dependent Care & Care Giving Resources For more information about EAP, go to member.magellanhealthcare.com. When you create an account, enter Principal Core as the program name.

Short Term Disability

Disability Insurance can replace a portion of your income if you’re unable to work if your sick or hurt.

Whole Life & Term Life

Additional life insurance helps provide peace of mind and financial security for the people who matter most in your life.

Accident

Helps pay for out-of-pocket costs associated with minor and major accidents – costs medical insurance may not cover.

Cancer

Cancer insurance can help offset costs associated with cancer treatment and recovery, so you can focus on getting well.

Benefit Hub – Employee Perks Benefits Mobile App Get information about your plans on the go! hanzo.verus.app

You have access to a discount marketplace! Just visit hanzo.benefithub.com Enjoy discounts, rewards, and perks on thousands of the brands you love in a variety of categories. Travel / Auto / Electronics / Apparel / Local Deals / Education / Entertainment / Restaurants / Health & Beauty / Sports & Outdoors

Additional Information How to Enroll or Make Changes Employee Navigator 1. Visit Employee Navigator at www.employeenavigator.com directly. 2. Click Login on the upper right hand side 3. Enter your username and password • If you have forgotten your username and/or password, please click "Forgot Your Password?" Then click "Don't know your username?" 4. Enter Company Identifier: Hattori 5. Enter First Name & Last Name 6. Enter the last 4 digits of your Social Security Number Trouble logging in? Call the Benefits Advocacy Team (BAT) at 833.476.5848.

COBRA Should you lose your coverage due to a qualifying event, you and your family will have the opportunity to elect a temporary extension of coverage called “COBRA” coverage. You do not have to show that you are insurable to elect COBRA coverage. COBRA eligible benefits include medical, dental and vision plans. Please note you will be responsible for 102% of the premium each month under COBRA (Hattori Hanzo Shears contribution will end). Additional information about your COBRA rights & responsibilities will be distributed to you under separate cover when necessary.

Contact Information United Healthcare – Medical Group #: 929968 866.633.2446 www.myuhc.com

Kaiser Permanente – Medical Group #: 607656 800.464.4000 www.kp.org

Principal – Dental Group #: 1165812 800.247.4695 principal.com/dentist

Colonial Life Benefits 800.325.4368 www.coloniallife.com

Principal – VSP Vision Group #: 1165812 800.247.4695 www.vsp.com/eye-doctor

Principal – Magellan EAP 800.450.1327 member.magellanhealthcare.com

Principal – Life/AD&D Group #: 1165812 800.247.4695 principal.com

Hattori Hanzo Shears/Duomo Human Resources [email protected]

When you create an account, enter Principal Core as the program name.

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