2023 Employee Benefits
TABLE OF CONTENTS 3 WELCOME 4
WHO IS ELIGIBLE
5
MEDICAL PLANS
8
ANTHEM BLUE CROSS HIGH 500 PPO
9
ANTHEM HRA 2000 AND 3500
10
ANTHEM BLUE CROSS HDHP PLAN WITH HSA
11 HSA 12
MEDICAL PLANS: KAISER LOW AND HIGH HMO (N. CA ONLY)
13
MINIMUM ESSENTIAL COVERAGE (MEC) WITH HOSPITAL INDEMNITY
14
WHERE SHOULD I GO FOR CARE?
15
DENTAL INSURANCE
16
VISION COVERAGE
17
LIFE / ACCIDENTAL DEATH AND DISABILITY INSURANCE
19
INCOME PROTECTION BENEFITS
20
VOLUNTARY BENEFITS
22 FSA 23
EMPLOYEE ASSISTANCE PROGRAM
24
HEALTHCARE ADVOCACY
26
ADDITIONAL BENEFITS
27
PLANNING FOR RETIREMENT
28
BENEFIT CARRIER CONTACT INFORMATION / RESOURCES
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WELCOME At Performant Financial, we recognize that our employees are our most valuable asset. Every employee contributes to the success of the company. Performant provides employees with a competitive and comprehensive benefits package designed to meet your needs and those of your family. This guide provides an overview of Performant’s benefits. In addition, a benefits website has been created for employees with documents relating to the benefits program, direct links to the carrier websites, detailed plan descriptions, and carrier contact information. Many of your general questions can be answered by contacting the carrier directly, or reviewing the plan information by visiting Performant’s benefit website at https://flimp.live/Performant-2023-Resource-Center or by scanning the QR code to the right with your mobile phone.
SCAN ME
We encourage you to review the information in this guide and explore the wide array of services, health information and wellness assistance available to you before making your benefit elections.
Benefits Package Your 2023 Benefits Package includes:
Medical
Flexible Spending Accounts
Health Savings Account
Employee Assistance Program
Dental
Health Advocate Services
Vision
Identity Theft Protection
Life / AD&D Insurance
Retirement Savings Plans
Disability Insurance
Paid Time Off Plans
Voluntary Benefits
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WHO IS ELIGIBLE Active, full-time employees regularly scheduled to work 30 or more hours per week are eligible for benefits. Benefits are effective on the first of the month concurrent with or following date of hire. Refer to the Employee Handbook for coverage eligibility during Leaves of Absence. You may elect to add your eligible dependents for medical, dental, vision, and voluntary dependent life insurance coverage. Eligible dependents can also receive Employee Assistance Program (EAP) and Health Advocate services. Your eligible dependents include: Your spouse or qualified domestic partner Your children or qualified partner’s children up to age 26 Your dependent child over the maximum age, who was covered under the plan prior to reaching he maximum age, with a qualifying physical or mental disability (additional documentation required by carrier) Note: Domestic partners or civil union partners are defined in the Benefits Enrollment Guide for partners. Refer to this guide for additional information on eligibility requirements and tax impacts of enrolling partners.
Making Changes to Your Benefits You may make changes to your benefit choices once a year during Performant’s Open Enrollment period. The benefit elections you make will be effective for a full 12 months (from January 1 – December 31) unless you have a qualified change in status or if your employment ends. Because many of your benefits are available on a pretax basis, the IRS requires you to have a qualified change in status in order to make changes to your benefit elections during the year. Examples of a qualified change in status include:
Marriage, legal separation or divorce Birth, adoption, or custody change of a dependent Death of a spouse/domestic partner or dependent Dependent ceases to satisfy requirement for dependent eligibility A change in employment status (either yours or your dependents’) from part-time to full- time, or full-time to part-time; or, A significant increase in the cost of Performant’s health care benefit offerings
If you have a qualified change in status and wish to make changes to your benefits, you must submit required documentation to Human Resources within 30 days of the change occurring. The requested change to your benefit elections will be effective the first of the month following the date of the qualified change in status. If the change is due to a court mandated order, coverage will be effective in accordance with the date specified by the order. The change to your benefits must be consistent with the change in family status. For example, if you have a new baby, you can enroll the child as a dependent under your current health plan, but you may not remove another dependent that is already covered. Note: Documentation is required to make changes to your benefit elections. For example, a birth certificate, marriage certificate, or proof of other coverage should be provided when requesting a change.
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MEDICAL PLANS To help you and your family live a healthy, happy lifestyle, Performant is pleased to offer quality medical coverage that provides choice, flexibility and affordability. Employees in California may choose between one PPO plan, two HRA plans and one HDHP plan with an HSA through Anthem Blue Cross, two HMO plans through Kaiser Permanente, or a Minimum Essential Coverage (MEC) with Hospital Indemnity benefits administered by SBMA. Employees outside of California may choose between the four Anthem Blue Cross plans and will have access to the Anthem Blue Cross national network of physicians and facilities, as well as the Minimum Essential Coverage (MEC) with Hospital Indemnity Plan. See starting on page 6 for how these plans work.
Your Prescription Drug Coverage When you enroll in the Anthem Blue Cross and Kaiser medical plans through Performant, you automatically receive prescription drug coverage. Your medical ID card is also your prescription drug ID card. To maximize savings, it is important for you to use in-network (or contracted) pharmacies. You can access Anthem Blue Cross pharmacy information directly on the Anthem Blue Cross website or by calling the number on the back of your ID card. Kaiser pharmacies are located on-site at Kaiser facilities.
Mail Ordering Discounting If you are taking maintenance medications on a regular basis, the mail order programs through Anthem Blue Cross and Kaiser may be advantageous for you. The mail order program through Anthem Blue Cross provides 90-day supply of medication and Kaiser provides 100-day supply of medication, for reduced copays. For more information, visit the carrier or benefits website, or contact the carrier directly using the customer service phone number on the back of your ID card. To access additional benefit information, including the Summary of Benefits and Coverage (SBC), please visit https://flimp.live/Performant-2023-Resource-Center.
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Medical Plan Comparison ANTHEM PPO HIGH IN-NETWORK
OUT-OFNETWORK
ANTHEM HRA 2000 IN-NETWORK
OUT-OFNETWORK
ANTHEM HRA 3500 IN-NETWORK
ANTHEM PPO HDHP
OUT-OFNETWORK
IN-NETWORK
OUT-OFNETWORK
$10,500
$2,250
$2,250
$3,000
$3,000
$4,500
$4,500
YOU PAY CALENDAR YEAR DEDUCTIBLE (CYD) Individual
$500
Member Family
$500
$2,000
N/A $1,500
$6,000
$3,500
N/A $1,500
$4,000
N/A $12,000
$7,000
$21,000
CALENDAR YEAR OUT-OF-POCKET MAXIMUM (INCLUDES DEDUCTIBLE) Individual
$2,000
$5,000
$5,000
$15,000
$7,000
$21,000
$3,000
$6,000
Family
$6,000
$15,000
$10,000
$30,000
$14,000
$42,000
$6,000
$12,000
COINSURANCE / COPAYS Coinsurance
10%
30%
20%
40%
20%
40%
20%
50%
Primary Care Office Visit
$15
30%*
$30
40%*
$30
40%*
20%*
50%*
Specialist Office Visit
$30
30%*
$30
40%*
$60
40%*
20%*
50%*
Urgent Care
$15
30%*
$30
40%*
$30
40%*
20%*
50%*
Inpatient Hospital
10%*
30%*
20%*
40%*
20%*
40%*
$100 + 20%*
50%*
Hospital Physician Services
10%*
30%*
20%*
40%*
20%*
40%*
20%*
50%*
Outpatient Hospital
10%*
30%*
20%*
40%*
20%*
40%*
20%*
50%*
Emergency Room
10%*
10%
20%*
20%*
20%*
20%*
$100 + 20%*
$100 + 20%*
Ambulatory Surgical Center (ASC)
10%*
30%*
20%*
40%*
20%*
40%*
20%*
20%*
Major Diagnostic (MRI, CAT, CT, PET)
10%*
30%*
20%*
40%*
20%*
40%*
20%*
20%*
RETAIL RX (UP TO 30-DAY SUPPLY) IN-NETWORK
IN-NETWORK
IN-NETWORK
IN-NETWORK
Tier 1
$10
$5 / $15
$5 / $15
$10*
Tier 2
$20
$40
$40
$25*
Tier 3
$35
$60
$60
$40*
Tier 4
30% up to $150
30% up to $250
30% up to $250
30% up to $200
* After deductible
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Medical Plan Comparison KAISER HMO HIGH
KAISER HMO LOW
ADVANCED MEC
IN-NETWORK
IN-NETWORK
IN-NETWORK
YOU PAY CALENDAR YEAR DEDUCTIBLE (CYD) Individual
$0
$500
Family
$0
$1,000
N/A
CALENDAR YEAR OUT-OF-POCKET MAXIMUM (INCLUDES DEDUCTIBLE) Individual
$1,500
$3,000
Family
$3,000
$6,000
Coinsurance
0%
20%
Primary Care Office Visit
$20
$20
Specialist Office Visit
$20
$20
Urgent Care
$20
$20
Inpatient Hospital
$250 per admission
20%*
Hospital Physician Services
$0
20%*
Outpatient Hospital
$20
20%*
Emergency Room
$100
20%*
Ambulatory Surgical Center (ASC)
$20
20%*
Major Diagnostic (MRI, CAT, CT, PET)
$0
20%*
N/A
COINSURANCE / COPAYS
The Plan provides the preventive items and services required under Section 2713 of the Public Health Service Act (PHS Act) and its implementing regulations
RETAIL RX (UP TO 30-DAY SUPPLY) OUT-OFNETWORK
IN-NETWORK
OUT-OFNETWORK
IN-NETWORK
Tier 1
$15
$15
Tier 2
$30
$30
Tier 3
30% up to $150
30% up to $150
Tier 4
N/A
N/A
Tier 5
N/A
N/A
OUT-OFNETWORK
IN-NETWORK
N/A
* After deductible Please Note: Kaiser plans are only available to employees who reside in Northern California.
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ANTHEM BLUE CROSS HIGH 500 PPO How It Works Because this plan is a PPO plan, each time you need medical treatment you have the freedom to decide where you receive your treatment. While each plan uses a PPO network, the schedule of benefits varies between the low PPO and high PPO plans. Greater cost savings are achieved when you use a provider in the Anthem Blue Cross PPO network.
You and Performant share the premium cost of your coverage. Your premium contributions are pretax and are automatically deducted from your paycheck. When you receive preventive and non-preventive care or fill prescriptions, you will pay a copay. You must meet an Annual Deductible before the plan begins to cover non-preventive care expenses subject to coinsurance like hospital stays and surgeries. You are responsible for 100% of non-preventive care costs up to your Annual Deductible. After you reach your Annual Deductible, you and the plan share the costs of your health care services. In-network, you will pay a $15 copay or 10% (this cost sharing is called coinsurance) for most services. For covered services, you will only pay coinsurance and copays up to the Out-of-Pocket Maximum. Once you reach this amount, the plan pays 100% of covered expenses for the rest of the year.
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ANTHEM HRA 2000 AND 3500 Your HRA health plan gives you access to a large network of doctors and hospitals and helps pay for certain costs when you need care. This health plan also comes with a reimbursement account to help you pay for eligible healthcare expenses for you and your covered dependents. HRAs are also a way for an individual or a family to pay for medical expenses without the funds being taxed by the government beforehand. The employee may not contribute to the HRA. Please note: Funds available for reimbursement are limited to the balance in your HRA and may not be used for copay services (such as doctors visits and urgent care)
Using the HRA The Company contributes to your account. $960 for individual employees | $1,320 for employees with dependent coverage (spouse/domestic partner, child(ren) or family coverage.
Your expenses are paid by your HRA. Your HRA pays your eligible deductible and coinsurance amounts.
You make all applicable copayments at the doctor’s office. These payments apply toward your deductible.
You pay your deductible. After you use all of your HRA funds, you then pay the rest of the deductible amount out of your own pocket.
After that, you pay only coinsurance. Once you have met your deductible, you share in the cost of the expenses. This is called coinsurance.
For Your Protection The out-of-pocket maximum provides financial protection in the event of a serious illness or injury. The out-of-pocket maximum includes your payments for covered in-network or out-of-network expenses, as applicable, and is withdrawn from your funds. The out-of-pocket maximum, however, does not include penalties (such as a late cancellation fee for a doctor’s appointment). After you reach your out-of-pocket maximum, the plan covers all expenses up to 100% for the rest of the year.
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ANTHEM BLUE CROSS HDHP PLAN WITH HSA Performant pays 100% of Employee Only Coverage—that means no premium cost to you. Performant offers a high deductible health plan (HDHP) that works in conjunction with an employee-owned Health Savings Account (HSA). The HDHP is a PPO plan, meaning you have the flexibility of seeking care from both in- and out-of-network doctors; however, the greatest savings are achieved by using providers in the Anthem Blue Cross PPO network. You and Performant share the premium cost of your coverage. Your premium contributions are pretax and are automatically deducted from your paycheck. In-network preventive care is covered at 100%. You must meet an Annual Deductible before the plan begins to cover non-preventive care expenses like specialist visits, lab work, prescriptions, and surgeries. You are responsible for 100% of non-preventive care costs, including prescriptions, up to your Annual Deductible. You can use the money in your HSA to help pay your Annual Deductible as well as additional qualified health care expenses. For information on qualified HSA expenses, visit https://flimp.live/Performant-2023-Resource-Center. After you reach your Annual Deductible, you and the plan share the costs of your health care services. For physician and hospital services in-network, the plan pays 80% and you pay 20% (this cost sharing is called coinsurance). For prescription drugs, you pay a flat amount: $10, $25, or $40, to fill your prescription. (This cost sharing is called a copay.) You will only pay coinsurance and copays up to the Out-of-Pocket Maximum. Once you reach this amount, the plan pays 100% of covered expenses for the rest of the calendar year. The family deductible and out-of-pocket limit are embedded, meaning the cost shares of one family member will be applied to the per person deductible and per person out-of-pocket limit; in addition, amounts for all covered family members apply to both the family deductible and family out-of-pocket limit. No one member will pay more than the per person deductible or per person out-of-pocket limit.
What is an HSA? An HSA is a tax-advantaged savings account. Pretax HSA dollars can be used to pay for eligible medical, prescription drug, dental, and vision care expenses. You own your account and can take it with you if you leave Performant. Your HSA dollars roll over year-over-year. After the age of 65, your HSA acts like any other retirement account (though funds can continue to be used for qualified expenses tax-free). When you sign up for the Anthem Blue Cross HDHP Plan with HSA, an HSA is automatically opened for you through Anthem Blue Cross.
HSA Record Keeping If you have an HSA, you are ultimately responsible for proving how the account is used because it is individually owned. To protect yourself in the event that you are audited by the IRS, keep records of all HSA documentation for at least as long as your income tax return is considered open (subject to an audit), or as long as you maintain the account, whichever is longer. Hold on to any insurer’s explanation of benefits statement that documents your expenses for services covered under your HDHP. Also, when you pay an expense from your HSA and the expense is not filed with your health insurance carrier (for example, a vision or dental expense not covered by insurance), make sure you save the receipt.
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HSA A Health Savings Account (HSA) is a personal savings account you can use to pay for qualified out-of-pocket medical expenses with pretax dollars — now or in the future. Once you’re enrolled in the HSA, you’ll receive a debit card to help manage your HSA reimbursements. Your HSA can also be used for your expenses and those of your spouse and dependents, even if they are not covered by the HDHP medical plan.
How a Health Savings Account Works Eligibility In order to be eligible to open an HSA and to be able to continue to make contributions, you must have a qualifying High Deductible Health Plan (HDHP). In addition:
You may not have any other health coverage that is not a qualified HDHP. You may not be enrolled in Medicare Part A or Part B. You may not be claimed as a dependent on someone else’s tax return. You or your spouse may not have a traditional Health Care Flexible Spending Account (FSA). You may not have received veterans’ benefits in the past three months.
Contributions You contribute on a pretax basis and can change how much you contribute from each paycheck up to the annual IRS maximum of $3,850 if you enroll only yourself or $7,750 if you enroll in family coverage. You can make an additional catch-up contribution if you are age 55 or older.
Eligible Expenses You may use your HSA funds to cover Medical, Dental, Vision and prescription drug expenses incurred by you and your eligible family members.
Using Your Account Use the debit card linked to your HSA to cover eligible expenses, or pay for expenses out of your own pocket and save your HSA money for future health care expenses. When you sign up for the Anthem Blue Cross HDHP Plan, an HSA is automatically opened for you through Anthem Blue Cross and a debit card is sent to you in a mail. Please note: HSA plan participants do not receive new cards every year. Your existing card will continue to work in the new plan year until the expiration date on the card. A new card will be sent to you prior to your card expiring.
Your HSA is always yours — no matter what. One of the best features of an HSA is that any money left in your account at the end of the year rolls over so you can use it next year or sometime in the future. And if you leave the Company or retire, your HSA goes with you so you can continue to pay for or save for future eligible health care expenses.
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MEDICAL PLANS: KAISER LOW AND HIGH HMO (N. CA ONLY) Kaiser Low HMO: How It Works As a member with Kaiser, you may receive care at any Kaiser facility in your area. The Kaiser plan requires that members select a Primary Care Physician (PCP). Your PCP works with you to coordinate your health care needs.
You and Performant share the premium cost of your coverage. Your premium contributions are pretax and are automatically deducted from your paycheck. You may only obtain care from Kaiser facilities in your service area. There is no out-of-network care except in urgent or emergency situations. When you receive non-preventive care such as office visits or fill prescriptions, you will pay a copay. There is no copay for preventive care. In-network preventive care is covered at 100% Brand and Specialty prescription drugs have a one-time per calendar year deductible of $100. You must meet an Annual Deductible before the plan begins to cover non-preventive care expenses such as hospital stays, surgeries, and lab work / x-rays. After you reach your Annual Deductible, you and the plan share the costs of your health care services. For inpatient stays or surgeries, the plan pays 80% and you pay 20%. For office visits, you pay a copay of $40; for lab work, you pay a copay of $10. For covered services, you will only pay deductibles, coinsurance, and copays up to the out-of-pocket maximum. Once you reach this amount, the plan pays 100% of covered expenses for the rest of the calendar year.
Kaiser High HMO Plan: How It Works As a member with Kaiser, you may receive care at any Kaiser facility in your area. The Kaiser plan requires that members select a Primary Care Physician (PCP). Your PCP works with you to coordinate your health care needs.
You and Performant share the premium cost of your coverage. Your premium contributions are pretax and are automatically deducted from your paycheck. You may only obtain care from Kaiser facilities in your service area. There is no out-of-network care except in urgent or emergency situations. When you receive non-preventive care such as office visits and lab test, hospital care, surgeries, x-rays, or fill prescriptions, you will pay a copay. There is no copay for preventive care. In-network preventive care is covered at 100%. For covered services, you will only pay copays up to the out-of-pocket maximum. Once you reach this amount, the plan pays 100% of covered expenses for the rest of the calendar year.
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MINIMUM ESSENTIAL COVERAGE (MEC) WITH HOSPITAL INDEMNITY The MEC plan provides preventive and hospital indemnity coverage. For your preventive services, you must stay within the MultiPlan network for the services to be covered. Your preventive office visits and lab work are covered at 100% when you utilize in-network providers. For hospital services, you can visit the provider of your choice, there is no network. This type of plan is a hospital indemnity plan that will pay a lump sum benefit for each covered service. You may be required to pay up front for services and then submit a claim to the insurance company for reimbursement. Note: Please refer to MEC Plan Document for coverage specifics.
How It Works: MEC Plan The MEC plan provides coverage for preventive care services as defined by the U.S. Health and Human Services (link below). Preventive care services as defined in the plan document will be paid at 100% for in-Network providers within the MultiPlan network. Filing a claim with SBMA is generally done by providers and is not the claimant’s responsibility. In fact, if a claimant’s provider is in your PPO network, they are contractually bound to file the claim for the claimant. Non-PPO providers will generally file the claim as well. In the event a non-PPO provider will not file a claim, the participant should ask for an itemized receipt and contact our Customer Care Team at the number provided on their ID card for instructions on how to do this manual filing. www.healthcare.gov/coverage/preventive-care-benefits Hospital indemnity is provided through Transamerica. Benefits are paid to you or to your provider if you provider is filing a claim on your behalf. This plan also includes a prescription benefit. You have open access to hospitals and pharmacies under this plan. Patient advocacy services are available to you to navigate your plan benefits coverage as well as the various health care systems. Advocates can research treatment options for you, help you find a provider and resolve claims issues on your behalf. These advocacy services include a nurse line available to you 24/7.
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WHERE SHOULD I GO FOR CARE? Find the Right Care Center CARE CENTER
Doctor’s Office
Convenience Care Clinic
Urgent Care Clinic
WHAT TYPE OF CARE WOULD THEY PROVIDE?
WHAT ARE THE COST AND TIME CONSIDERATIONS?
You need routine care or treatment for a current health issue. Your primary doctor knows you and your health history, can access your medical records, provide preventive and routine care, manage your medications and refer you to a specialist, if necessary.
• • • •
• Often requires a copayment and/or coinsurance • Normally requires an appointment • Little wait time with scheduled appointment
You can’t get to your doctor’s office, but your condition is not urgent or an emergency. Convenience care clinics are often located in malls or retails stores offering services for minor health conditions. Staffed by nurse practitioners and physician assistants.
• Common infections (e.g. strep throat) • Minor skin conditions (e.g. poison ivy) • Flu shots • Pregnancy tests • Minor cuts • Earaches
• Often requires a copayment and/or coinsurance similar to office visit • Walk-in patients welcome with no appointments necessary, but wait times can vary
You may need care quickly, but it is not an emergency, and your primary physician may not be available. Urgent care centers offer treatment for non-life threatening injuries or illnesses. Staffed by qualified physicians.
• Sprains • Strains • Minor broken bones (e.g. finger) • Minor infections • Minor burns
• Often requires a copayment and/or coinsurance usually higher than an office visit • Walk-in patients welcome, but waiting periods may be longer as patients with more urgent needs will be treated first
WHY WOULD I USE THIS CARE CENTER?
• • • • •
Emergency Room
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You need immediate treatment of a very serious or critical condition. The ER is for the treatment of lifethreatening or very serious conditions that require immediate medical attention. Do not ignore an emergency. If a • situation seems life threatening, take • action. Call 911 or your local emergency • number right away. • •
Routine checkups Immunizations Preventive services Manage your general health
Heavy bleeding Large open wounds Sudden change in vision Chest pain Sudden weakness or trouble walking Major burns Spinal injuries Severe head injury Difficulty breathing Major broken bones
• Often requires a much higher copayment and/or coinsurance than an office visit or urgent care visit • Open 24/7, but waiting periods may be longer because patients with life-threatening emergencies will be treated first
DENTAL INSURANCE Performant’s benefit program also includes two types of dental plans – the Lincoln Low DPPO Plan and Lincoln High DPPO Plan. Lincoln offers access to the nation’s largest dentist networks, delivering the best value for your employee benefits dollar. With both plans, you may seek care from any dentist; however, benefits are optimized when obtained through an in-network participating dentist. When searching for a dentist, use the Lincoln network. Participating dentists agree to receive contracted rates as “payment-in-full.” These contracted PPO rates provide deeper discounts that result in savings to you and your family.
LINCOLN DENTAL PLAN LOW PLAN
HIGH PLAN
You Pay Calendar Year Deductible Per Person Per Family Benefit Maximum Per Person (of the family) Preventive Services Periodic Oral Evaluation; Radiographs; Lab and Diagnostic Tests; Cleanings/ Prophylaxis; Fluoride Treatments; Sealants; Space Maintainers Basic Services Restorations (fillings); Simple Extractions; Oral Surgery (includes extractions); Periodontics; Endodontics Major Services Inlays/Onlays/Crowns; Dentures and other Removable Prosthetics; Fixed Partial Dentures (Bridges) Orthodontia Both Adults and Child(ren)
$50 $150
$50 $150
$2,000
$3,000
$0
$0
20%*
10%*
50%*
40%*
50% up to a lifetime maximum benefit of 40% up to a lifetime maximum benefit of $2,000 per individual $3,000 per individual
* After Deductible
Out-of-Network Dental Benefits Services from an out-of-network dental provider under your dental plans will pay the In-Network coverage at the Usual Customary, and Reasonable Fee (UCR). A usual fee is the amount which an individual dentist regularly charges and receives for a given service or the fee actually charged, whichever is less. A customary fee is within the range of usual fees charged and received for a particular service by dentists of similar training in the same geographic area. A reasonable fee schedule is reasonable if it is usual and customary. The out-of-network reimbursement under both dental plans is in the 80th percentile of UCR.
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VISION COVERAGE Performant employees and dependents may elect to enroll in the group vision plan through Lincoln. The program allows members to access both in- and out-of-network providers; however, greater savings are obtained if care is received through an in-network provider. In addition, doctors in the Lincoln network provide both eye exams and eye wear, making it convenient for you to obtain total eye care services with one provider. If you decide not to see a Lincoln provider, you will receive a lesser benefit and typically pay more out of pocket. You will be required to pay the provider in full at the time of your appointment and submit a claim to Lincoln for partial reimbursement.
LINCOLN VISION PLAN
Exams Lenses Single Bifocal Trifocal Lenticular Polycarbonate Frames Contact Lenses (in lieu of glasses) Elective Frequency Examination Lenses Glasses Contacts
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IN-NETWORK
OUT-OF-NETWORK
You Pay $10
Reimbursement Up to $40
$25 copay $25 copay $25 copay $25 copay
Up to $40 Up to $60 Up to $80 Up to $80
Covered in full for children to age 19
Not Covered
70% over balance over $130 allowance
Up to $45
Balance over $125 allowance
Up to $125
Every 12 months Every 12 months Every 24 months Every 12 months
LIFE / ACCIDENTAL DEATH AND DISABILITY INSURANCE Performant provides all eligible employees with Basic Life and Accidental Death & Dismemberment (AD&D) Insurance at no cost to you through Lincoln. All regular employees working 30 hours per week are automatically enrolled for these coverages on the first of the month following or concurrent with your date of hire. Be sure to complete beneficiary information at the time of enrollment and update your information as appropriate. You may also elect to purchase Voluntary Life and/or AD&D Insurance for yourself and your eligible dependents. Note: If you or your spouse do not enroll in the Voluntary Life plan when you are first eligible, you may enroll at a later date. However, ALL coverage amounts will require proof of good health and are subject to approval by Lincoln. In addition, employees who wish to increase amounts outside of initial eligibility or who elect coverage in excess of Guarantee Issue are subject to Evidence of Insurability.
Basic Life / AD&D Insurance For non-exempt employees, in the event of your death, this plan pays your beneficiary a benefit equal to 1 times your covered annual earnings to a maximum of $100,000. For exempt employees, the plan pays your beneficiary a benefit equal to 1 times your covered annual earnings to a maximum of $400,000. Please note, per IRS regulations, premiums paid by the company for amounts of life insurance in excess of $50,000 are subject to imputed income taxation. In the event of your accidental death, this plan pays your beneficiary an additional benefit equal to your basic life benefit. If you are seriously injured as the result of an accident (for example: loss of your eyesight, paralysis), this plan may pay a partial benefit to you.
Basic Life and AD&D
EXEMPT EMPLOYEES
NON-EXEMPT EMPLOYEES
1 times annual salary up to $400,000
1 times annual salary up to $100,000
Supplemental / Voluntary Employee Paid Life & Disability Benefits COVERAGE
LIMIT
GUARANTEED ISSUE AT INITIAL ELIGIBILITY
Increments of $10,000
Up to 5 times annual salary, up to $500,000
$450,000
Voluntary Spouse Life/ADD
Increments of $5,000
Not to exceed $250,000 or 100% of your employee-elected supplemental voluntary coverage
$30,000
Voluntary Dependent Child Life/ADD
Increments of $2,000
Up to a maximum of $10,000
Voluntary Life/ADD
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Voluntary Life / AD&D Insurance You have the opportunity to supplement your Basic Life and AD&D Insurance by purchasing supplemental voluntary insurance coverage through Lincoln for yourself and your eligible dependents. You must elect to purchase supplemental voluntary Life and AD&D coverage for yourself in order to cover your spouse and/or child(ren). If you leave Performant, you may be eligible to port or convert your voluntary life policy.
Employee You may purchase supplemental coverage in increments of $10,000, to a maximum amount equal to five times your annual salary or $500,000. Guarantee Issue = $450,000.
Spouse or Domestic Partner You may purchase supplemental coverage in increments of $5,000, limited to 50% of the employee’s basic and voluntary life coverage amount up to $250,000. Benefits will be paid to the employee. Guarantee Issue = $30,000.
Child(ren) You may purchase life insurance coverage for your child(ren) of $10,000. Each eligible dependent child must have the same amount of insurance. * For rate information, please contact Human Resources*
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INCOME PROTECTION BENEFITS If you become ill or injured and are unable to work, Performant provides income protection benefits through Lincoln. These benefits have been designed to protect your income in a situation where you become unable to work due to a disability. Performant provides Long Term disability to all benefit-eligible employees at no cost to you. Exempt Employees are provided company paid Short Term Disability Insurance. Non-Exempt Employees residing in a state without a mandatory State Disability Plan may opt to enroll in a voluntary Short-Term Disability Plan. Please note that specific restrictions apply to these benefits.
Voluntary Short-Term Disability Benefits EXEMPT EMPLOYEES
NON-EXEMPT EMPLOYEES
Coverage
66.67% of your pre-disability salary to a $2,500 maximum for 13 weeks.
55% of your pre-disability salary to a weekly maximum of $1,173 for 13 weeks.
When Benefits Begin
Benefit begins after 8 days of disability.
Benefit begins after 8 days of disability.
Election Required
No
Yes
Company-Provided Long-Term Disability Benefits EXEMPT AND NON-EMPLOYEES Coverage
60% of your pre-disability earnings up to a maximum benefit of $15,000 per month until you recover or reach your Social Security Normal Retirement Age, whichever is sooner.
When Benefits Begin
Benefit begins after 90 days of disability.
Election Required
No
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VOLUNTARY BENEFITS Voluntary benefits are a cost-effective solution to help offset out-of-pocket medical expenses by paying you the plan benefits directly instead of your health care provider. These benefits are employee-paid and are a great supplement to your medical plan. Performant Financial Benefits Program offers four options through Lincoln Accident Insurance for employees to choose from. These plans are fully portable which means that you can keep your coverage at the same rate if you change jobs or retire. Note that the below benefit tables are not an exhaustive list of the available benefits under the Voluntary Benefit plans through Performant. For a complete list and official benefit summaries, please visit https://flimp.live/Performant-2023-Resource-Center.
Accident Insurance Accident insurance pays out a lump sum if you become injured as a result of an accident. It allows you to claim disability insurance by allowing you to claim benefits even if the injuries you incur do not keep you out of work. Accident insurance may also complement health insurance if an accident causes you to have medical expenses that your health insurance doesn’t cover. Accident insurance covers qualifying injuries, which might include a broken limb, loss of a limb, burns, lacerations or paralysis. In the event of your accidental death, accident insurance pays out money to your designated beneficiary. While health insurance companies pay your provider or facility, accident insurance pays you directly.
ELIGIBLE EXPENSES Emergency Room Visits
Hospital Stays
Fractures and Dislocations
Medical Exams – including major diagnostic exams
Physical Therapy
Transportation and Lodging – if you are away from home when the accident happens
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How Accident Insurance Works Accident insurance policies can provide you with a lump sum paid directly to you that will help pay for a wide range of situations, including initial care, surgery, transportation and lodging, and follow-up care. Here’s how it works: A set amount is payable based on the injury you suffer and the treatment you receive. Benefits are payable directly to you (unless you specify otherwise) and can be used as you see fit. Coverage is available for you, your spouse and eligible dependent children. You do not need to answer medical questions or have a physical exam to get basic coverage. Accident insurance covers injuries that happen on the job or off the job unlike workers’ compensation, which only covers on-the-job injuries. Benefit payments are not reduced by any other insurance you may have with other companies.
Critical Illness Insurance While major medical insurance is vital, it doesn’t cover everything. If you suffer from a serious illness, such as cancer, a stroke or a heart attack, major medical insurance may not provide the coverage you need. Critical illness insurance will help ease the financial strain and help you worry while you recover.
SAMPLE OF COVERED CONDITIONS Heart Attack
Multiple Sclerosis
Stroke
Alzheimer’s Disease
How Will a Critical Illness Claim Get Paid? After purchasing critical illness insurance, if you suffer from one of the serious illnesses covered by your policy, you’ll be paid in a lump sum. The payment will go directly to you instead of to a medical provider. The payment you receive can be used for many things, including: Child care costs Medical expenses Travel expenses for you and your family Lost wages from missed time at work Living expenses And more Since the payment is made to you, the money can be used for anything you need while you focus on recovering.
Parkinson’s Disease
Major Organ Failure
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FSA Flexible Spending Accounts (FSAs) allow you to pay for eligible expenses using tax-free dollars. Important: There is a “use it or lose it” rule imposed by the IRS. If you do not spend all the money in your Health Care or Dependent Care FSA by March 31 of the following year for expenses incurred from January 1 – December 31, unused dollars will be forfeited per IRS regulations for pretax contributions.
Health Care FSA
Dependent Care FSA
Contribute up to $3,050 per year, pretax, to pay for copays, prescription expenses, lab exams and tests, contact lenses and eyeglasses. Note: If you are a participant in an HSA, you are not eligible for the Health Care FSA.
Contribute up to $5,000 per year ($2,500 if married and filing separate tax returns), pretax, to pay for day care expenses associated with caring for elder or child dependents that are necessary for you or your spouse to work or attend school full-time. You cannot use your Health Care FSA to pay for Dependent Care expenses.
Use It or Lose It If you do not spend all the money in this FSA by March 15, per IRS regulations for pretax contributions, unused dollars will be forfeited.
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EMPLOYEE ASSISTANCE PROGRAM We offer our employees and their eligible family members free access to licensed counselors through our Employee Assistance Program whether or not you elect other benefits coverage. Through this coverage, employees and their families receive immediate support and guidance and assessments and referrals for further services. Five sessions a year are covered at no cost to you. You can contact the EAP for help with the following:
Marital or Family Problems
Stress, Anxiety or Depression
Substance Abuse
Financial Issues
Aging Parents
It’s important to note that all EAP conversations are voluntary and strictly confidential. If you and your counselor determine that additional assistance is needed, you’ll be referred to the most appropriate and affordable resource available. Although you’re responsible for the cost of referrals, these costs are often covered under your Medical plan. To find out more: Visit GuidanceResources.com username: LFGSupport password: LFGSupport1 or call: 888.628.4824
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HEALTHCARE ADVOCACY Healthcare Advocacy is a personalized service that helps your plan members navigate the complexities of the healthcare system. Healthcare Advocacy is your partner, building healthcare solutions centered around each unique individual’s needs. We call it “Healthcare. As it should be.”
Awareness
FINDING CARE: Transparency & Access
PLAN BASICS: Explanation & Understanding of Benefits General Plan Questions Assistance with Copayments, Deductible & Out-of-Pocket Costs
Finding In-Network Providers, Treatments & Facilities Get Second Opinions & Alternative Care Options Schedule Appointments & Transfer Medical Records Compare Cost & Quality
Clarify Covered Services Understanding Pharmacy Benefits & Formularies
PROBLEM SOLVING: PERSONAL CARE:
ent m e ov r p
Rx Medication Review Cost Savings Options
m
Case Management Support
I
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One-to-One Preventive Care Planning
Eng a g em en t
Individual Solutions
Hands-On Support & Solutions Claims Explanations & Support Medical Bill Reviews & Audits Fee & Payment Negotiation Appeals & Approvals Understanding Pharmacy Benefits & Formularies
Obtain help with: Understanding your health plan, finding doctors in your network, making your doctor appointments, getting cost estimates for procedures, resolving billing issues, processing medical record transfers and more. Access to all of your benefit information is available in one app. But how do you get it? It’s easy - follow these simple steps!
1. 2. 3.
ACCESS FROM ANY DEVICE
Online: www.thebenefitsapp.com/ performant Download: Google Play or App Store: thebenefitsapp
CREATE AN ACCOUNT
Enter Your Email Enter the Access Code: “pfc” Create Your Password
ACCESS YOUR BENEFITS ANYWHERE, ANYTIME You’re now set up with access to your Benefits information anytime you need it – from any device – PC, laptop, tablet or smartphone.
Contact a Healthcare Advocate One touch access to a specialist to help with all your questions. Link to all benefits information & contacts Call the right people with questions. No more doubts! Get plan details All medical, dental, and vision insurance plan information in one place. Store ID cards ID Cards stored in one place & sent seamlessly to the doctor.
Call anytime 855.975.6928 Telemedicine through the app Telemedicine is available by phone call or through your benefits app.
Much, much more Benefit communications, find providers, etc.
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ADDITIONAL BENEFITS Paid Time Off Plans Performant recognizes that in order to do your work well, you also need time away from work to refresh and renew as well as to care for yourself and your family members. Performant offers vacation, sick and holiday plans. Details of these plans can be found in the Employee Handbook and related memorandums.
Employee Discounts via Perks at Work Performant Financial benefit eligible employees have access to a discount program that offers discounts from 30,000 merchants worldwide. It is also designed to help you find perks that matter to you. When you create a profile and provide feedback, Perks at Work will work to help you find perks that matter to you. As an added benefit, employees can invite up to five family members.
Simply sign up and start saving:
Go to www.perksatwork.com and click on Register for Free Use your Performant email address to set up your account If you have questions, visit the Help Center or email
[email protected]
Note: You, your spouse and your dependent children (up to five family members), all can use Employee Discounts even if they are not enrolled in any of Performant’s benefit plans.
ID Theft Protection Performant Financial Benefits Program provides you the opportunity to purchase ID Theft solutions directly through ID TheftSmart at affordable group rates. As an ID TheftSmart member, you’ll have exclusive access to your own experienced, licensed investigator in the event you think you’re at risk or discover that your identity is compromised. You will also receive:
Comprehensive identity theft restoration, including employment, motor vehicle and other non-credit searches. Continuous credit monitoring, with email notices alerting you to certain activity in your credit file which is commonly associated with identity theft. Personal credit score with detailed analysis.
Note: ID TheftSmart is a direct bill arrangement and not a payroll deduction.
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PLANNING FOR RETIREMENT
Increase Your Retirement Savings cannot exceed the IRS limit of
401(k) Through Fidelity
Funded with
PRETAX Contributions
$22,500
Your
ANNUAL Contributions
If you are AGE 50+ you can make an additional contribution of $7,500
IRS Maximum contribution limit for 2023 is $22,500. If you are age 50 or older, you can contribute an additional $7,500 “catch-up” contribution.
Retirement Savings Plans Employees become eligible to participate in the 401(k) on the first day of the month following 30 days of employment. Newly eligible employees will receive information directly from Fidelity regarding Auto Enrollment, election options and auto increase functions. Contributions are deducted from your eligible compensation before federal (and most state) income taxes are withheld from your paycheck. As a result, your taxable income is reduced, so you pay less in taxes. You may also contribute after-tax dollars from your paycheck into a Roth 401(k). For more details, please contact Fidelity. You can invest your contributions in select investment funds offered by the plan. Each investment option has a varying level of risk. Rollovers from other qualified retirement accounts, including Individual Retirement Accounts (IRAs), are permitted. Contact Fidelity at 800-890-4015 or visit www.401k.com for more information about your 401(k), to opt-out, or to make changes to contributions and investment selections.
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BENEFIT CARRIER CONTACT INFORMATION / RESOURCES PLAN Healthcare Advocacy
GROUP OR POLICY CUSTOMER WEBSITE LINK NUMBER / NAME SERVICE NUMBER Access Code: pfc
855.975.6928
www.thebenefitsapp.com/performant
L01203
800.888.8288
www.anthem.com
906
800.464.4000
www.kp.org
Lincoln Dental High & Low
00001D042130-00000
877.275.5462
www.lincolnfinancial.com
Lincoln Life & Disability
09-LF1052
877.275.5462
www.lincolnfinancial.com
Lincoln Vision
000010272734-00000
www.lincolnfinancial.com
Anthem Blue Cross High 500 PPO Plan Anthem Blue Cross HRA 2000 and 3000 Plans Anthem Blue Cross HDHP Plan With HSA Kaiser HMO Plans
Lincoln Accident
0000401055
877.275.5462 877.275.462 877.275.5462
Lincoln Critical Illness
0000401054
877.275.5462
www.lincolnfinancial.com
Username: LFGSupport Password: LFGSupport1
888.628.4824
www.guidanceresources.com
Navia Benefit Solutions
FNL
800.669.3539
www.naviabenefitsolutions.com
Perks at Work
Performant Financial Corp.
ID TheftSmart
Performant
Lincoln EAP – Employee Connect
Fidelity
81609
Risk Strategies Stacy Lawrence (Account Manager)
N/A
SCAN ME
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[email protected]
800.543.9927 800.890.4015 954.332.6124
www.lincolnfinancial.com
www.perksatwork.com www.idtheftsmart.com/performant www.401k.com www.risk-strategies.com
[email protected]