Employee Benefits Enrollment Guide
Plan Year: January 1, 2015 to December 31, 2015
Design © 2008-2011 Zywave, Inc. All rights reserved.
Welcome to Your Benefits
Open Enrollment!
G&P Trucking Company, Inc. is pleased to continue providing employees a comprehensive benefits
package including medical, prescription drug, dental, vision, life insurance, disability, and flexible
spending options.
Elections you make during open enrollment will become effective January 1, 2015.
We encourage you to take the time to review this brochure, educate yourself about the options
available, and choose the best coverage level for you and your family.
The Open Enrollment timeframe is limited.
Please be sure to set up a one-on-one meeting with a
Colonial Representative to make benefit elections.
Who is Eligible?
If you are a full-time employee (working 30 or more hours per week) you
are eligible to enroll in the benefits described in this guide. Your qualified
dependent family members are eligible for medical, dental, vision,
supplemental medical and dependent life coverage.
How to Enroll
The first step is to set up a one-on-one meeting with a Colonial
Representative. During this time, you will review your current benefit
elections. Verify your personal information and make any changes if
necessary. Make your benefit elections. Once you have made your
elections, you will not be able to change them until the next open
enrollment period unless you have a qualified change in status.
When to Enroll
The open enrollment period runs from December 8, 2014 to
December 12, 2014. The benefits you elect during open enrollment
will be effective from January 1, 2015 through December 31, 2015.
How to Make Changes
After December 12, 2014, and unless you have a qualified change in
status, you cannot make changes to the benefits you elect until the next
open enrollment period. Qualified changes in status include: marriage,
divorce, legal separation, domestic partnership status change, birth or
adoption of a child, change in child’s dependent status, death of spouse,
child or other qualified dependent, change in residence due to an
employment transfer for you, your spouse or domestic partner,
commencement or termination of adoption proceedings, or change in
spouse’s or domestic partner’s benefits or employment status.
What’s New for
2015?
Highlighted Sections in this Enrollment Guide
Medical & Prescription Drug Insurance Comparison .................................................................. I
2015 Costs: Medical/Rx, Dental, Vision & Life Coverage .......................................................... II
Guardian Dental Insurance ...................................................................................................... III
Guardian Vision Insurance ....................................................................................................... IV
Guardian Basic & Dependent Life Insurance ............................................................................. V
AM Public Supplemental Medical Insurance ............................................................................ VI
Health Care & Dependent Care Flexible Spending Accounts ................................................... VII
Endeavor Insurance Services, Inc. Contacts .......................................................................... VIII
eDocHome: Virtual Urgent Healthcare..................................................................................... IX
Questions & Answers ................................................................................................................ X
I. Medical & Prescription Drug Insurance Comparison
Your new medical carrier for 2015 is United Healthcare of the River Valley. Several benefit changes have been
made to the medical and prescription drug benefits for the upcoming plan year January 1 to December 31,
2015. The major medical deductible has decreased, and the supplemental medical insurance benefit will
transition to a voluntary benefit to reduce major medical liability if you choose. In addition, the new plan
continues to offer affordable co-pays for primary care office visits and prescription drugs. The following table
summarizes the new United Healthcare benefits that will be in place effective January 1, 2015.
SERVICE
Physician Visit
Deductible
- Individual
- Family
Co-Insurance
Co-Insurance Maximum
Maximum Out-of-Pocket
- Individual
- Family
Plan Benefit
Co-pay $30 Primary Care/
$60 Specialist
SERVICE
Plan Benefit
Urgent Care
$60 Copay
Emergency Room
$250 Copay
$5,000 per employee
x 2 per family
You pay 30%
after Deductible
$1,600 per employee
x 2 per family
$6,600 per employee
$13,200 per family
In-Patient Care
Applies to Deductible
and Coinsurance
Out-Patient Care
Applies to Deductible
and Coinsurance
Wellness and
Preventive Care
Covered at 100%
INCLUDES Deductible & Copays
Prescription Drugs
- Retail (30 day supply) /
Mail Order (90 day supply)
- Tier 1
- Tier 2
- Tier 3
- Tier 4
$10 / $25
$35 / $87.50
$60 / $150
$100 / $250
Lab & X-Ray
- Preventive
- Office
- Outpatient
- Major Diagnostics
(MRI, MRA, CAT, PET)
100%
100%
Applies to Deductible
and Coinsurance
Applies to Deductible
and Coinsurance
II. 2015 Costs: Includes Medical/Rx, Dental, Vision & Life Coverage
G&P Trucking Company, Inc. payroll deductions will be as shown.
EMPLOYEE WEEKLY DEDUCTIONS
Individual
Only
Individual &
Spouse
Individual &
Children
Individual &
Family
Employee Benefit Package
$50.00
$102.25
$95.50
$113.25
Employee Benefit Package (Tobacco Users)
$59.40
$121.44
$113.52
$134.64
Voluntary Supplemental Medical Option 2 - $1,500
$7.11
$16.36
$12.09
$21.33
Voluntary Supplemental Medical Option 1 - $3,000
$12.49
$28.72
$21.23
$37.46
EE - $52.94
ES - $139.58
EC - $100.05
EF - $174.91
Employer Contribution for Tobacco & Non-Tobacco User
III. Guardian Dental Insurance
When you are enrolled in the medical plan, you also receive dental benefits. We are pleased to announce that
there are no plan changes to your dental benefits in 2015. G&P Trucking’s plan allows you to seek treatment
from the dentist of your choice, or you may enhance your benefit by seeking dental services from a Guardian
in-network provider.
Services
Benefit Description
Preventive Services
Diagnostic & Preventive – 100%
Deductible
Applies to basic and major services only – $100 per employee, x 3 per family
Basic Services
Fillings, Simple Extractions, Oral Surgery, Periodontics – 80%
Major Services
Root Canal, Crowns, Prosthodontic Benefits – 50%
Annual Benefit
$1,000 per member
Orthodontia
Not Covered
IV. Guardian Vision Insurance
When you are enrolled in the medical plan you also receive vision benefits. We are pleased to announce that
there are no plan changes to your vision benefits in 2015. If you utilize the services of a provider listed in the
Davis Vision Preferred Provider Directory, your benefits include routine vision exams for a $25 co-pay, and a
$25 co-pay for a large selection of brand-name, designer frames, lenses, and contact lens options.
Services
Benefit Description
Vision Exams
$25 Co-pay applies to one vision exam per calendar year
Lenses
$25 Co-pay applies to lenses once per calendar year*
Contact Lenses
$25 Co-pay applies to medically necessary lenses ($210 allowance) once per calendar year
Frames
$25 Co-pay applies to frames once every other calendar year*
Network
Davis Vision Network
Child Age Limit
20; 26 if a full time student
*Certain allowances apply based on type of lenses or frames selected
V. Guardian Basic & Dependent Life Insurance
When you are participating in the medical plan you also receive a $10,000 group life and accidental death and
dismemberment (AD&D) insurance benefit. A Dependent spouse enrolled in the medical plan receives a
$5,000 life insurance benefit, and each enrolled child receives a $2,500 benefit. Please update your
beneficiary information during your one-on-one meeting with the Colonial Representative.
VI. AM Public Supplemental Medical Insurance
To keep major medical insurance coverage affordable, most plans require the insured to pay a certain amount
of the expense in the form of deductible and out of pocket exposure before benefits start. The larger these
amounts are, the lower the health insurance rates generally are. Lower rates are good, but with a higher
deductible, individuals face a larger burden when they have to pay medical bills for an unexpected
hospitalization or out patient procedures.
That’s where AM Public steps in. It begins with paying the costs you normally have to pay that are applicable
to the major medical deductible. Here’s how the benefit works:
AM Public Supplemental Medical coverage will be fully voluntary in 2015.
In-Hospital Benefit
 The In-Hospital benefit pays up the benefit chosen per person, per calendar year for hospital
confinement due to sickness, injury or accident.
 This Benefit is also payable for hospital emergency room treatment due to sickness or injury (sickness
requires a hospital confinement within 24 hours of the hospital emergency room treatment). You may
supplement your United Healthcare Medical plan with one of the following two options:
 Option 1 includes a $3,000 In-Hospital GAP benefit per covered person and is applicable to the
$5,000 major medical deductible. *By selecting option 1, you will automatically receive option 1
Outpatient Benefit Rider.
 Option 2 includes a $1,500 In-Hospital GAP benefit per covered person and is applicable to the
$5,000 major medical deductible. *By selecting option 2, you will automatically receive option 2
Outpatient Benefit Rider.
Outpatient Benefit Rider
 This rider pays for out-patient treatment for an injury or sickness provided by a physician at a hospital,
physician’s office, outpatient surgical or emergency facility, or diagnostic testing facility licensed to
provide outpatient treatment.
 The benefit pays in addition to the base in-hospital policy and covers treatment, supplies and other nonphysician-related outpatient charges.
 Option 1 includes a $1,500 Outpatient GAP benefit with a family calendar year maximum equal to two
times the per person calendar year benefit maximum. This benefit is applicable to the $5,000 major
medical deductible.
 Option 2 includes a $750 Outpatient GAP benefit with a family calendar year maximum equal to two
times the per person calendar year benefit maximum. This benefit is applicable to the $5,000 major
medical deductible.
Members enrolled in the AM Public program will receive a separate ID card, which should be provided to the
In-Hospital facility or outpatient treatment center at time of service.
As with the major medical insurance plan, your provider will file the claim to the AM Public Supplemental
Medical insurer. Benefits applicable under the AM Public program will then be paid directly to the provider.
The Supplemental Medical plan serves as first dollar coverage. It applies to dollar one of your major medical
deductible up to the In-Hospital or Outpatient benefit included with either the base or buy up option selected.
VII. Health Care & Dependent Care Flexible Spending Accounts
G&P Trucking Company, Inc. provides you the opportunity to pay for out-of-pocket medical, dental, vision and
dependent care expenses with pre-tax dollars through Flexible Spending Accounts. You must enroll/re-enroll
in the plan to participate for the plan year January 1 to December 31, 2015. You can save approximately 25%
of each dollar spent on these expenses when you participate in a FSA.
A health care FSA is used to reimburse out-of-pocket medical expenses incurred by you and your dependents.
A dependent care FSA is used to reimburse expenses related to care of eligible dependents while you and your
spouse work.
Contributions to your FSA come out of your paycheck before any taxes are taken out. This means that you
don’t pay federal income tax, Social Security taxes, or state and local income taxes on the portion of your
paycheck you contribute to your FSA. You should contribute the amount of money you expect to pay out of
pocket for eligible expenses for the plan period. If you do not use the money you contributed it will not be
refunded to you or carried forward to a future plan year. This is the use-it-or-lose-it rule.
The maximum that you can contribute to the Health Care Flexible Spending account is limited by the IRS in
2015 to $2,550.
The maximum that you can contribute to the Dependent Care Flexible Spending Account is $5,000 if you are a
single employee or married filing jointly, or $2,500 if you are married and filing separately.
The following example shows how you can save money with a flexible spending account.
Bob and Jane’s combined gross income is $30,000. They have two children and file their income taxes jointly. Since Bob and Jane expect to spend
$2,000 in adult orthodontia and $3,300 for day care next plan year, they decide to direct a total of $5,300 into their FSAs.
Without FSAs
With FSAs
$30,000
$30,000
0
-5,300
30,000
24,700
Federal
-2,550*
-1,755*
State
-900**
-741**
FICA
-2,295
-1,890
After-tax earnings:
24,255
20,314
-5,300
0
$18,955
$20,314
Gross income:
FSA contributions:
Gross income:
Estimated taxes:
Eligible out-of-pocket
Medical and dependent care expenses:
Remaining spendable income:
Spendable income increase:
$1,359
*Assumes standard deductions and four exemptions.
** Varies, assume 3%.
The example above is for illustrative purposes only. Every situation varies and we recommend that you consult a tax advisor for all tax advice.
VIII. eDocHome: Virtual Urgent Healthcare
HEALTHCARE DESIGNED AROUND YOU. Avoid the cost and trip to an Urgent Care or the Emergency Room.
Frustrated with how hard and how expensive it can be to see a doctor? G&P Trucking has joined eDocHome to
present a suite of innovative consumer-driven healthcare solutions is designed to provide fast access to
superior healthcare at no cost to you. Get the care you need. Anytime. Anywhere. Save on expensive trips to
the doctor, urgent care or emergency room. We provide our members with 24/7/365 access to a doctor
though the convenience of online video and/or phone consultations.
Doctors by Phone/Video Conference.
Feel better now! 24/7 access to a doctor is only a call or click away – anytime, anywhere with no consultation
fee. With Teladoc, you can talk to a doctor by phone or online video consult to get a diagnosis, treatment
options and prescription if necessary. Save time and money by avoiding crowded waiting rooms in the doctor’s
office, urgent care clinic or ER. Just use your phone, computer, smartphone or tablet to get a quick diagnosis
by a U.S. licensed physician.
 On-demand healthcare – wherever, whenever
 Treatment for common medical issues such as colds, flu, poison ivy, respiratory infections, bronchitis,
pink eye, sinus problems, allergies, urinary tract infections and ear infections
 16 minute average callback time
 Consultations for all ages – from children to seniors
 U.S. board-certified doctors with an average 15 years practice experience
 Upon request, Teladoc can share consult information with your doctor
IX. Endeavor Insurance Services, Inc. Contacts
Representative
Toll Free Contact Number
Email Address
Rani Mullinax
888-877-6641 extension 207
rmullinax@eisadvantage.net
Marshall Edens
888-877-6641 extension 213
medens@eisadvantage.net
For questions concerning medical, dental, vision, life or supplemental medical insurance options, or for
questions concerning the open enrollment process, please contact the G&P Trucking Company Human
Resources Department or an Endeavor Insurance
Services, Inc. representative listed above.
X. Questions & Answers
Changes that can be made effective January 1, 2015:
 Elect voluntary supplemental medical plan (Option 1 or 2).
 Enroll or terminate individual and/or dependent coverage.
 Enroll in the Flexible Spending Account Plan.
Forms to be completed if making changes:
 During open enrollment, it is very important that each employee meets with a Colonial Life enrollment
advisor to review benefits and make any necessary changes.
What forms MUST be completed?
 Flexible Spending Account Enrollment Form/Direct Deposit Form – to enroll, re-enroll, or waive
enrollment for the new plan year January 1 to December 31, 2015.
 Dependent social security information for all those currently enrolled with dependent medical, dental,
and vision coverage
 The Pre-Tax Insurance Form must be completed by everyone. You must elect to participate to continue
having your premiums withheld on a pre-tax basis.
Where do I find these forms?
 Contact Human Resources for all forms.
When are the forms due and where do I return them?
 All forms are due by December X, 2014 and must be returned to Human Resources.
Who do I contact with questions?
 Contact Human Resources with any questions you may have, or
 Contact an Endeavor Insurance Services, Inc. representative via email, or call toll free.
Other Information:
 New elections must be made to the Flexible Spending Account to continue participation.
The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer.
The text contained in this Guide was taken from various summary plan descriptions and benefit information. While every effort was
taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and
the actual plan documents the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance
Portability and Accountability Act of 1996. If you have any questions about your Guide, contact Human Resources.