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2019 OPEN ENROLLMENT GUIDE
What’s Inside... Eligibility & Enrollment Qualified Life Events
3
Medical Plan Options, Prescription Drug Coverage
4
Voluntary Supplemental Health Benefits
5
Dental Coverage 6
Vision Coverage 7
Health Savings & Flexible Spending Accounts, Commuter Benefits
8-9
Basic Life & Accidental Death & Dismemberment and Long Term Disability Insurance
10
Short Term Disability and
Whole Life Insurance
11
Employee Assistance Program, PTO Buy-Up Program. Workplace Giving Program
12
Contact Information
13
Benefits Information Guide: Important Regulations
I
Medicare Part D Update
II
HIPPA Privacy Notice III-IV
CHIP Notice V-VI
Health Care Reform Update VII
Team Member Benefits Open Enrollment Guide
Team Member Benefits Open Enrollment Guide
Monday, October 22 — Friday, November 16, 2018
Welcome to Guest Services’ Benefits Open Enrollment
This Benefits Enrollment Guide explains the benefit options available to you for the 2019 plan year, which will be effective January 1, 2019 through December 31, 2019.
Each year, Guest Services takes a close look at our benefits package to ensure that we offer the best value and quality coverage for you and your family. Please make sure to evaluate your needs, learn about your benefit options and make smart decisions about your health and well-being. We will continue to offer a comprehensive selection of benefits that you and your family can use to protect your health, finances and future.
New for 2019! Voluntary Benefits: Guest Services will offer Critical Illness, Accident and Hospital Indemnity coverage through Aflac for the 2019 plan year. Blue Rewards Means Money Back: Taking steps to get and stay healthy has its rewards! You and your covered spouse can each earn a $175 debit card for healthy behavior to use for medical expenses. If you enroll in CareFirst coverage, you will be emailed program details. If you enroll in Kaiser Permanente, you will also be sent information about their similar offering. Smoking Cessation Program and Smoker Surcharge: Guest Services is committed to the health and well-being of our team members. In order to support the health and wellness of our employees by encouraging them to be tobacco-free, Guest Services will require tobacco/nicotine users enrolled in our medical plan to pay a surcharge, or participate in an approved Smoking Cessation Program for free. Please review our new Smoking Cessation Program policy and Tobacco/Nicotine User Attestation for more details about the surcharge waiver/refund process.
How and When to Enroll
Guest Services will operate an active open enrollment for 2019 benefits. Even if you are keeping the same benefits, you must re-enroll. Ask your manager for a 2019 Benefits Election Form between October 22 and November 16, 2018. Send the completed form back by November 16th to Human Resources via mail to 3055 Prosperity Avenue, Fairfax, Virginia 22031, via fax to (703) 584-9870, or via email to [email protected].
If you are interested in purchasing Short Term Disability or Whole Life insurance with Unum, visit: https://www.plane.biz/Logons/GuestServicesInc2019/default.htm. Should you have any questions during the online enrollment about Short- Term Disability and Whole Life Insurance, please feel free to reach out to Unum’s Customer Support at 1-800-350-4029, Monday - Friday, 8:00 am — 8:00 pm EST during your annual enrollment window.
If you are interested in purchasing Critical Illness, Accident or Hospital Indemnity insurance with Aflac, visit http://www.aflac.com/guestservices for detailed information or www.mymarketlink.com/GuestServices to enroll.
To log on, enter your username (Employee ID). Your password is your date of birth in the YYYYMMDD format, your first initial (lower case), your last initial (UPPER CASE), plus an exclamation point (!).
Example: Rebecca Gray, Employee ID: 123456, Date of Birth: August 14, 1962 Login ID: 123456 Password: 19620814rG!
Should you have any questions during the online enrollment, please reach out to the Voluntary Benefit Service Center at 1-888-317-3769, Monday through Friday, 9:00 am – 5:00pm EST.
Eligibility & Enrollment Regular, full time employees (30+ hrs/week) of Guest Services are eligible to enroll in benefits.
Who Else Is Eligible? You may enroll your eligible dependents when you enroll yourself. Dependents who are eligible for benefit coverage include:
Your legal spouse who is not eligible for other group medical
or dental coverage through his/her employment Your dependent children
Included in the definition of dependent child(ren) are:
• Your naturally born child(ren), legally adopted child(ren),
step-child(ren) or court-ordered dependent child(ren) for whom you are the court-appointed legal guardian
• Your dependent child(ren) up to age 26 whether they are a
full-time student or not. Coverage ends on the day prior to the 26th birthday
• Your continuously covered disabled dependent child(ren) [if
disabled prior to age 26] who are incapable of self- sustaining employment and dependent upon you for support, regardless of age
Qualified Life Events The choices you make during enrollment will be in effect for the 12-month plan year from January 1, 2019 — December 31, 2019. However, you may make changes during the year if you experience a Qualified Life Event.
If you need to report a life event during the year, you will need to contact Human Resources with the necessary changes within 30 days of the event.
Some examples of life events are: • Birth or adoption of a child • Marriage or divorce • Death or loss of a dependent (including dependent child ceasing to be an eligible dependent by attaining the maximum
dependent age) • Change in your spouse’s employment status causing loss or gain of benefits coverage • Change in your own employment status • Court decree requiring coverage for your dependent child(ren)
Medical Plans Guest Services provides medical coverage to all regular status, full-time employees. We will continue to offer three plans from CareFirst. Our employees in Washington, DC, and parts of Maryland and Virginia have the option to enroll with Kaiser Permanente instead. All CareFirst plans include prescription drug coverage administered by Express Scripts. The chart below provides a snapshot of the medical plans’ coverages.
This summary is intended only to highlight your benefits and should not be relied upon to fully determine your coverage. Please refer to the Summary Plan Description for a full listing of benefits and to determine if services require prior authorization.
CareFirst and Kaiser Medical Coverage Medical Plans (In-Network)
CareFirst PPO CareFirst HSA/
HDHP 1500 CareFirst HSA/
HDHP 5000 Kaiser HMO
DC; portions of MD, VA
Annual Deductible (Individual/ Family)
$750/$1,500 Embedded
$1,500/$3,000 Non-embedded
$5,000/ $10,000
Embedded
$0
Out-of-Pocket [OOP] Limit (Individual/Family)
$2,250/$4,500 Medical
$6,350/$12,700 Medical|RX
$6,350/ $12,700
Medical|RX
$3,500/$9,400 Medical|RX|Vision
Preventive Care/ Screening/Immunization
$0
$0
$0
$0
Prenatal/Postnatal Care
$0
$0
$0
$0
Primary Care/ Mental/Behavioral Health/ Substance Abuse Disorder
$30 Deductible, 20%
Coinsurance Deductible, 20%
Coinsurance
$15
Specialist/Urgent Care
$60 Deductible, 20%
Coinsurance Deductible, 20%
Coinsurance
$25
Acupuncture/
Chiropractic* visits
Deductible, 20% Coinsurance (*$1,500 per benefit period)
Deductible, 20%
Coinsurance
Deductible, 20%
Coinsurance
$25 (20 visits per
year)
Diagnostic Tests (x-ray, blood work)
Deductible, 20% Coinsurance
Deductible, 20% Coinsurance
Deductible, 20% Coinsurance
$0
Imaging (CT, PET scan, MRI) Deductible, 20%
Coinsurance Deductible, 20%
Coinsurance Deductible, 20%
Coinsurance
$50
Emergency Medical Transportation
Deductible, 20% Coinsurance
Deductible, 20% Coinsurance
Deductible, 20% Coinsurance
$0
Emergency Room
$150, Deductible, 20%
Coinsurance
Deductible, 20% Coinsurance
Deductible, 20% Coinsurance
$100
Hospitalization/Delivery Deductible, 20%
Coinsurance Deductible, 20%
Coinsurance Deductible, 20%
Coinsurance
$250
Payroll Deductions $$$ $$ $ $$$$
Prescription Drug Coverage
Generic Drugs
Brand/Specialty Drugs
RX OOP Limit (Indiv./Family)
25% up to $50
50% up to $300
$2,000/$6,000
Deductible, 20%
Coinsurance Deductible, 20%
Coinsurance see above
Deductible, 20%
Coinsurance Deductible, 20%
Coinsurance see above
$20 at Kaiser
pharmacy $20-45 at Kaiser
pharmacy See above
New! Voluntary Benefits from
Guest Services will offer Aflac’s accident, critical illness and hospital indemnity plans for the 2019 plan year. Benefits can be used to pay for medical expenses like deductibles or coinsurance as well as, non-medical expenses such as additional childcare, bills and groceries. Supplemental health benefits are intended to alleviate your financial burden from unanticipated injuries, sicknesses and hospital stays, so you can focus on recovery!
Accident Insurance Accident insurance pays a specified benefit amount when you or a covered family member are injured as a result of a covered accident. You may choose between basic and enhanced coverage, and benefits may be used for both medical and non-medical expenses resulting from a covered accident. The plan provides both on and off the job coverage for covered injuries, treatments and services. For an example of what is covered under the accident plan, please review the table below. Accident Benefits Basic Plan Enhanced Plan ER and Urgent Care Treatment $100 without X-ray; $125 with X-ray $200 without X-ray; $250 with X-ray Ground Ambulance $200 $400 Major Diagnostic Testing $100 $200 Fractures and Dislocations $120 - $4,000 dependent on injury $240 - $8,000 dependent on injury
Critical Illness Insurance Critical illness insurance provides you with a lump sum benefit if you are diagnosed with a covered critical illness while enrolled in coverage. You may choose to elect $10,000, $20,000 or $30,000 coverage, which will be paid directly to you and you may use the benefit payment however you see fit. Covered critical illnesses include cancer, heart attack, stroke and many more. In addition, the critical illness plan includes a $50 health screening benefit, which will be paid to you when you participate in one of the covered health screening tests, for example, a mammography, chest x-ray or colonoscopy.
Hospital Indemnity Insurance Hospital indemnity insurance pays benefits to help cover the out-of-pocket expenses that may result from a hospital confinement, whether expected or unexpected. The plan includes a hospital admission benefit and confinement benefits for each day you are confined to the hospital or intensive care unit. You may choose between the basic or enhanced plan, both of which are outlined in the table below. Hospital Indemnity Benefits Basic Plan Enhanced Plan Hospital Admission $1,000 once per confinement $2,000 once per confinement Hospital Confinement $100 per day $200 per day Hospital Intensive Care $100 per day $200 per day
Each plan is fully portable and does not require Evidence of Insurability if you enroll during the 2019 Open Enrollment. If you would like to advantage of the opportunity to learn more or enroll in these benefits, please visit: http://www.aflac.com/guestservices for detailed information or www.mymarketlink.com/GuestServices to enroll.
Network: PDP Plus
Plan A Plan B
Coverage Type In-Network
% of Negotiated Fee*
Out-of-Network90% of R&C
Fee**
In-Network % of Negotiated
Fee*
Out-of-Network 90% of R&C Fee**
Type A: Preventive† (cleanings, exams, X-rays) 100% 100% 80% 80%
Type B: Basic Restorative (fillings, extractions)
80% 80% 80% 80%
Type C: Major Restorative (bridges, dentures)
50% 50% 50% 50%
Type D: Orthodontia 50% 50% Not Covered Not Covered
Deductible††
Individual $50 $50 $50 $50 Family $100 $100 $100 $100 Annual Maximum Benefit
Per Person $1,500 $1,500 $750 $750 Orthodontia Lifetime Maximum
Per Person $1,500 $1,500 Not Covered Not Covered
Child(ren)’s eligibility for dental coverage is from birth up to age 26. *Negotiated Fee refers to the fees that participating dentists have agreed to accept as payment in full for covered services, subject to any copayments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change. **R&C fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of (1) the dentist’s actual charge, (2) the dentist’s usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife. †Type A services do not apply to the Annual Maximum Benefit ††Applies to Type B and C Services only
Dental
Guest Services Inc
Guest Services
H
SUMMARY OF BENEFITS
40%OFF
Complete pair of prescription eyeglasses
20% OFF
Non-prescription sunglasses
20% OFF
Remaining balance beyond plan coverage
These discounts are not insured benefits and are for in-network providers only.
• You’re on the Insight Network
• For a complete list of in-network providers near you, use our Enhanced Provider Locator on eyemed.com or call 1-866-804-0982
• For LASIK providers,
call 1-877-5LASER6
Vision Care Services
In-Network Member Cost
Out of Network Reimbursement
Exam With Dilation as Necessary $0 Copay Up to $50
Retinal Imaging Up to $39 N/A
Frames $0 Copay; $130 allowance, 20% off balance over $130 Up to $70
Standard Plastic Lenses
Single Vision $20 Copay Up to $50
Bifocal $20 Copay Up to $75
Trifocal $20 Copay Up to $100
Lenticular $20 Copay Up to $125
Standard Progressive Lens $70 Copay Up to $75
Premium Progressive Lens∆
$90 Copay - $115 Copay Up to $75
Tier 1 $90 Copay Up to $75
Tier 2 $100 Copay Up to $75
Tier 3 $115 Copay Up to $75
Tier 4 $70 Copay, 20% off retail less $120 Allowance Up to $75
Lens Options (paid by the member and added to the base price of the lens)
UV Treatment $15 N/A
Tint (Solid and Gradiant) $15 N/A
Standard Plastic Scratch Coating $15 N/A
Standard Polycarbonate - age 19 and over $40 N/A
Standard Polycarbonate - under age 19 $0 Up to $5
Standard Anti-Reflective Coating $45
N/A
Premium Anti-Reflective Coating∆
$57 - $68
N/A Tier 1
$57 N/A
Tier 2
$68 N/A Tier 3
20% off Retail Price N/A
Photochromic/Transitions $75
N/A Polarized 20% off Retail Price N/A
Other Add-Ons and Services 20% off Retail Price N/A
Contact Lens Fit and Follow-up (Contact lens fit and two follow-up visits are available once a comprehensive eye exam has been completed.)
Standard Contact Lens Fit & Follow-Up: $40 N/A
Premium Contact Lens Fit & Follow-Up: 10% off Retail Price N/A
Contact Lenses (Contact Lens allowance includes materials only)
Conventional $0 copay, $130 allowance, 15% off balance over $130 Up to $105
Disposable $0 copay, $130 allowance, plus balance over $130 Up to $105
Medically Necessary $0 copay, Paid-In-Full Up to $210
Laser Vision Correction
LASIK or PRK from U.S. Laser Network 15% off the retail price or 5% off the promotional price N/A
Hearing Care
Hearing Health Care from 40% off hearing exams and low price guarantee
Amplifon Hearing Network on discounted hearing aids
Frequency
Examination Once every calendar year
Lenses (in lieu of contact lenses) Once every calendar year
Contacts (in lieu of lenses) Once every calendar year
Frame Once every calendar year
QL-0000032742
∆ Premium progressives and premium anti-reflective designations are subject to annual review by EyeMed’s Medical Director and are subject to change based on market conditions. Fixed pricing is reflective of brands at the listed product level . All providers are not required to carry all brands at all levels. Benefits are not provided from services or materials arising from: 1) Orthoptic or vision training, subnormal vision aids and any associated supplemental testing; Aniseikonic lenses; 2) Medical and/or surgical treatment of the eye, eyes or supporting structures; 3) Any eye or Vision Examination, or any corrective eyewear required by a Policyholder as a condition of employment; Safety eyewear; 4) Services provided as a result of anyWorkers’ Compensation law, or similar legislation, or required by any governmental agency or program whether federal, state or subdivisions thereof; 5) Plano (non-prescription) lenses; 6) Non-prescription sunglasses; 7) Two pair of glasses in lieu of bifocals; 8) Services or materials provided by any other group benefit plan providing vision care 9) Services rendered after the date an Insured Person ceases to be covered under the Policy, except when Vision Materials ordered before coverage ended are delivered, and the services rendered to the Insured Person are within 31 days from the date of such order. 10) Lost or broken lenses, frames, glasses, or contact lenses will not be replaced except in the next Benefit Frequency when Vision Materials would next become available. Benefits may not be combined with any discount, promotional offering, or other group benefit plans. Standard/Premium Progressive lens not covered-fund as a Bifocal lens. Standard Progressive lens covered-fund Premium Progressive as a Standard. Benefit allowance provides no remaining balance for future use within the same benefit year. Fees charged for a non-insured benefit must be paid in full to the Provider. Such fees or materials are not covered.
Underwritten by Combined Insurance Company of America, 5050 Broadway, Chicago, IL 60640, except in New York. This is a snapshot of your benefits. The Certificate of Insurance is on file with your employer.
Additional discounts
Take a sneak peek before enrolling
Health Savings & Flexible Spending Accounts and Commuter Benefits
Guest Services is pleased to offer Health Savings Accounts, Health Care and Dependent Care Flexible Spending Accounts, administered by Bank of America and WageWorks. See page 8 for a comprehensive look at the differences between these plans.
Health Savings Accounts (HSA) You may use the money in your HSA to pay for qualified medical expenses. HSA funds roll over and accumulate year to year if not spent. You own the money in your HSA and it stays with you! It’s a great way to reduce your taxable income now and prepare for your financial future.
Federal guidelines state you may contribute up to a maximum of $3,500 per year as an individual and $7,000 per year as a family.
Health Care FSA When you enroll in a Health Care FSA, you will need to decide on your annual contribution amount for the 2019 calendar year (January - December).
It is important to estimate your share of your eligible health care related expenses you are likely to incur in the 2019 calendar year.
You may use your Health Care FSA to pay for medical, prescription, dental and vision care expenses that are eligible for reimbursement under IRS guidelines. Reimbursement for eligible expenses may be requested for yourself, your spouse or your dependents.
Federal guidelines state you may contribute up to a maximum of $2,650 per year.
Dependent Care FSA The Dependent Care FSA lets you use pretax dollars toward qualified dependent care. You can contribute up to $5,000 ($2,500 if married but file taxes separately) for the Dependent Care FSA for children under age 13 and for disabled adults in your care.
If you elect to contribute to the Dependent Care FSA, you may be reimbursed for:
The cost of child or adult dependent day care (in or
out of your home)
Nursery schools and preschools (excluding kindergarten), and summer day camp
All 2019 FSA funds must be used before the end of the 2019 grace period (March 15, 2020) or will be forfeited pursuant to IRS rules.
Commuter Benefits WageWorks administers our commuter benefits program. You may elect to pay for commuting expenses on a pre-tax basis.
Eligible expenses include:
Parking - Qualified parking is defined as parking on or
near your work or on or near a location from which you commute by mass transit (e.g.: bus, train station, vanpool stops and monthly garage parking). You may deposit up to a maximum of $255 per month for parking expenses.
Mass Transit - Qualified transit is defined as transit
passes, a bus, railroad, subway, ferry, tramcar or commuter van pool that is used for transportation to and from work. You may deposit up to $255 per month for transit expenses.
Any remaining balance in your transportation account will roll over into the following plan year.
HSA vs. FSA
Health Savings Account
Health Flexible Spending Account
Dependent Care Flexible Spending Account
Who owns the account?
You do. You can take it with you, even if you retire, change
jobs or health plans.
Guest Services
Guest Services
Is a certain type of health plan
required with this account?
Yes, a High Deductible Health
Plan (HDHP).
No
No
Who can contribute to the account?
You (through pre-tax payroll contributions orindividual tax
deductible contributions)
You (via payroll deduction)
You (via payroll deduction)
Is there a maximum annual
contribution limit?
$3,500 (Individuals)
$7,000 (Families)
$2,650
$5,000
Are catch-up contributions allowed
(for those 55 years and over)?
Yes. $1,000 annual limit
N/A
N/A
Does the money in your account carry
over from year to year?
Yes
No. “Use it or Lose it”
No. “Use it or Lose it”
Can you invest the funds in the
account?
Yes, if the account balance
exceeds $1,000
N/A
N/A
Can the money in your account be withdrawn on a taxable basis after age 65?
Yes
No
No
Does this account include a debit card you can use to pay
for qualified medical expenses?
Yes
Yes
No
Do you earn interest on the money in your account?
Yes, the money in your
account can earn interest tax free.
No
No
When is the money in your account available to you?
As soon as it is deposited into your account.
The full contribution amount is
available on the first day of your plan year.
As soon as it is deposited into your account.
What are the tax advantages?
Money in your account that is
used to pay for qualified health care
expenses is tax free.
Your contributions are tax-free and reimbursements are free
of income taxes.
Your contributions are tax-free and reimbursements are free
of income taxes.
Basic Life and Accidental Death & Dismemberment (AD&D) Insurance Guest Services recognizes that life insurance can provide critical financial protection to you and your loved ones. We offer Basic Term Life Insurance and Accidental Death and Dismemberment insurance in the amount of your annual base salary for each benefit at no cost to you up to $400,000.
Additional Term Life Insurance Supplemental Employee Term Life Insurance—1x –5x base annual salary options up to $300k. Dependent Term Life insurance - $2,000 for legal spouses and children up to age 26. Evidence of Insurability is required for this Open Enrollment window for first-time elections or coverage increases. You will need to complete a separate application form from Reliance which can be obtained from Human Resources.
Long-Term Disability Insurance Guest Services offers Long-Term Disability (LTD) insurance at no cost to you. LTD coverage offers protection for lost income due to an illness or injury after 180 consecutive days of disability.
Hourly and Salaried Employees with < 5 years of service—The benefit pays up to 50% of your monthly base earnings up to a maximum monthly benefit of $5,000.
Salaried Employees with > 5 years of service - The benefit pays up to 66% of your monthly base earnings up to a maximum monthly benefit of $5,000.
Emergency Medical Leave Taking good care of our employees who have taken good care of our customers is very important to Guest Services. If personal illness or an off-the-job injury prevents you from working, we offer a unique and wonderful 100% income replacement benefit for full-time employees who have worked for us for at least five years.
Upon demonstrated and documented personal medical need, eligible employees may apply for EML of up to 160 hours for hourly employees, and up to 360 hours for salaried employees.
This benefit may be used at once or intermittently per five- year period for an eligible illness, with appropriate medical certification. The five-year EML usage period begins on the 5th anniversary of the employee’s hire or rehire date and resets on that anniversary date every five years thereafter. EML hours may not be carried over into subsequent five-year periods. Unused EML hours are forfeited at the end of the five-year period and are not compensable.
To apply for EML, contact Human Resources at 703/849- 9380 when the need arises.
Good to Know: Value of Disability Insurance The risk of disability is higher than you may think. It can affect you at any age.
Over 1 in 4 20-year-olds will become disabled before retirement A 30-year-old man is more likely to become disabled and need disability insurance than to die and need life
insurance. 1 in 8 workers will be disabled for 5 or more years during their careers
Besides the medical costs, becoming disabled will likely leave you unable to work. Even a short time without income can bring financial troubles. That’s where long-and short-term disability insurance step in.
Short-Term Disability Insurance Guest Services offers Individual Short Term Disability Insurance through Unum. Coverage is available to all eligible employees ages 17 to 69* who are actively at work. Individual Short Term Disability Insurance can pay you a percentage of your monthly salary if you become injured or ill due to a covered off-the-job disability or covered pregnancy.
You can apply for a monthly benefit of 40%, 50% or 60% of your gross monthly salary.
Premium Deductions Premiums are paid through the convenience of payroll deduction beginning with the first paycheck you receive in January 2018. All coverage elected during this enrollment will be effective January 1st, 2019.
Portability All benefits are 100% portable with no increase in rate even if you leave employment or retire from Guest Services, Inc., at which point premiums will be directly billed to your home.
Why Purchase STD Insurance at Work? • You own the policy so you can keep it even if you leave the company or retire. Unum will bill you directly for the same premium amount.
• Coverage becomes effective on the first day of the month in which payroll deductions begin.
• Your policy is guaranteed renewable, until age 72, as long as you pay the premiums on time.
• Affordable premiums are based on your age on the policy effective date and are deducted from your paycheck.
Whole Life Insurance Benefit eligible employees have the option to purchase additional Whole Life Insurance for themselves and their eligible dependents through Unum. Rates vary depending on age and the amount of coverage selected. Premiums will be conveniently deducted from your paycheck. Your premiums are level for life.
What is Whole Life Insurance Whole Life offers “living benefits” you can use when you
need them, as well as a death benefit. Cash value. This policy accumulates cash value.* You
can borrow funds from this value as needed. Living benefit option rider. If you are diagnosed with a
terminal illness, you can request up to 100% of your policy’s benefit amount and use it for any purpose.**
Why Purchase Life Insurance at Work? Whole Life rates. The rates available through your
employer are typically more affordable than those available elsewhere.
Age-based premiums. Premiums are based on your age when you purchase, and don’t increase as you get older. So the earlier you buy, the lower your premium will be for the life of your policy.
Guaranteed issue. Generally available during the initial
enrollment at your workplace. When it’s offered to you, you can purchase coverage up to a set amount, without medical exams or health questions. If you don’t purchase the maximum amount, you have the option to increase it up to that level during future enrollments — no questions asked!#
Coverage Options Available:
* The policy accumulates cash value based on a non-forfeiture interest rate of 4.5% and the 2001 CSO mortality table. The cash value is
Who Can Have It? What’s The
Benefit Amount? How Long can They Keep It?
Individual employee coverage
(ages 15-80)
You can choose to purchase cover-
age for $4.00, $8.00 or
$12.00 per week.+-
You can keep it as long as you want
it. If you leave your employer, you would be billed directly
at home.
Individual spouse coverage
(ages 15-80)
You can purchase coverage for
$4.00 per week.+-
If you leave your employer, you can
keep your spouse’s policy
and be billed directly
at home.
Individual child coverage
No employee or spouse purchase
needed. Available to
eligible children, stepchildren,
legally adopted children and
grandchildren (14 days until their
26th birthday) of the primary
insured adult
You can purchase coverage for
$3.00 per week.+-
Your children can keep it, even if
you leave your em-
ployer. You would be billed directly
at home.
guaranteed and will be equal to the values shown in the policy. Cash value will be reduced by any outstanding loans against the policy. ** You can request an advance, up to 100% of your benefit amount up to $150,000 maximum if you are terminally ill and are expected to live 12 months or less (24 months or less in IL, MA, and WA). †† Coverage becomes effective the first day of the month your payment is deducted from your paycheck. If you leave your job, Unum will bill you directly # If you increase your coverage later, you receive an additional policy for the increased amount. The premiums will be based on your age at the time you increase the coverage. +- Actual benefit amount is based on the employee or dependent’s age when the coverage is issued
Employee Assistance Program Guest Services is pleased to offer you an Employee Assistance program through Reliance.
This plan is a company-paid program that provides assistance to you and your family members in the event of a personal issue including financial and legal difficulties, child care, elder care and many other issues.
Your employee assistance program is only a phone call or click online away! Toll-free: 855-RSL-HELP http://rsli.acieap.com
PTO-Buy Up Program All regular employees accrue PTO based on service hours after an initial waiting period. This flexible PTO bank can be used for Vacation Time, Sick Days, Personal Time Off - whatever works best for you. In most locations, your PTO bank is a ‘use it or lose it’ plan and you may not carry over unused PTO days into the next calendar year.
If your manager approves, you may buy an additional one or two weeks of PTO through payroll deductions. You can only elect PTO Buy-Up during the open enrollment window.
Workplace Giving Program At Guest Services, we believe that contributing to the communities where we work and recognizing the “power of giving” are important to every member of the Guest Services family. As we assume that responsibility and assist those less fortunate or challenged by circumstances beyond their control, we invite you to share in the process with us. The Workplace Giving Program allows each and every one of us to help those who need it the most so that we can share in the joy of giving.
Whether it’s one volunteer hour or one dollar, you can make a difference in someone’s life. When we join together, it’s remarkable how those dollars and hours add up! It is easy and it will mean the world to those in need.
This opportunity is completely voluntary; participation is entirely up to you. The program is set up so that you can support the causes that are most important to you. To participate, contact human resources for a brochure that lists participating organizations. Simply select one or more organizations from this list and designate any donation in dollar increments that you would like to contribute each pay period. Your contribution will be deducted from your paycheck.
To find out more about Guest Services’ Work Place Giving Program, email [email protected] or call 703-849-9380.
BENEFIT PROVIDERS3055 Prosperity Avenue, Fairfax, VA 22031 | (703) 849-9300
/guestservicesinc @[email protected]
For questions on other benefits, contact Human Resources at 703-849-9382 or [email protected].
PROVIDER WEBSITE CONTACTMedical Coverage (Preferred Provider Organization)CareFirst BlueCross Blue Shield www.carefirst.com Phone: 800-628-8549
Provider Location www.bcbs.com Phone: 800-810-BLUE
Your Plan Account Information www.carefirst.com/myaccount
Prescription (Express Scripts) www.express-scripts.com Phone: 855-778-1517
Medical Coverage (Health Maintenance Organization)Kaiser Permanente (DC, MD, VA only)Group#: 4473-0
www.kp.org Phone: 800-777-7902
Dental CoverageMetLife Network: PDP Plus; Group#: 315201 Group Name: Guest Services
www.metlife.com/mybenefits Phone: 800-942-0854
Vision CoverageEyeMed Network: Insight; Group#: 1013915
www.enroll.eyemed.com Phone: 866-804-0982
Health Savings Account (HSA)Bank of America www.myhealth.bankofamerica.com Phone: 866-791-0250
Flexible Savings Accounts (FSA) – Health and/or Dependent CareWageWorks http://mybenefits.wageworks.com Phone: 866-279-8385
Fax: 888-866-3312
Core Benefits (Life Insurance, Accidental Death & Dismemberment, Long-Term Disability)Reliance Standard www.reliancestandard.com Phone: 800-351-7500
Voluntary BenefitsAFLAC (Accident, Critical Illness, Hospital Indemnity) UNUM (Short Term Disability, Whole Life)
www.aflacgroupinsurance.com www.unum.com/employees
Phone: 800-433-3036 Phone: 800-635-5597
401K Retirement SavingsPrincipal Financial GroupPlan#: 454475
www.principal.com Phone: 800-547-7754
Commuter BenefitsWage Works www.wageworks.com Phone: 877-924-3967
Employee Assistance ProgramReliance Standard http://rsli.acieap.com
[email protected] (email)Phone: 855-775-4357
Employee HelplineEthics Point www.ethicspoint.com Phone: 877-220-1672
Employment VerificationThe Work Number www.theworknumber.com Employer Code:
19551
COBRAWage Works http://mybenefits.wageworks.com Phone: 877-722-2667
Fax: 877-353-2948
Benefits Information Guide │ I
Patient Protection – Patient
Access to Obstetrical and
Gynecological Care
You do not need prior authorization from
from any other person (including a
primary care provider) in order to obtain
access to obstetrical or gynecological care
from a health care professional in our
network who specializes in obstetrics or
gynecology. The health care professional,
however, may be required to comply with
certain procedures, including obtaining
prior authorization for certain services,
following a pre-approved treatment plan,
or procedures for making referrals. For a
list of participating health care
professionals who specialize in obstetrics
or gynecology, call CareFirst at 1-800-
722-2467 or Kaiser HMO at 1-800-464-
4000.
Patient Protection - Designation of
PCP
You have the right to designate any
primary care provider who participates in
the network and who is available to
accept you or your family members. Until
you make this designation, Kaiser HMO
will designate one for you. For children,
you may designate a pediatrician as the
PCP. For information on how to select a
PCP with Kaiser HMO and for a list of
primary care providers, log onto http://
info.kaiserpermanente.org or call 1-800-
464-4000.
Women’s Health and Cancer Rights
Act
On October 21, 1998, the Women’s Health
and Cancer Rights Act became effective.
This law requires group health plans that
provide coverage for mastectomies to also
cover reconstructive surgery and
prostheses following mastectomies. As the
Act requires, we have included this
notification to inform you about the law’s
provisions. The law mandates that a plan
participant receiving benefits for a
medically necessary mastectomy who
elects breast reconstruction after the
mastectomy will also receive coverage for:
1. Reconstruction of the breast on which
the mastectomy has been performed, 2.
Surgery and reconstruction of the other
breast to produce a symmetrical
appearance, 3. Prostheses, 4. Treatment
of physical complications of all stages of
mastectomy, including lymphedema. This
coverage will be provided in consultation
with the attending physician and the
patient, and will be subject to the same
annual deductibles and coinsurance
provisions that apply for the mastectomy.
Health Insurance Portability
and Accountability Act
(HIPAA) – State Children's
Health Insurance Program
(SCHIP)
Loss of other coverage: If you decline
enrollment for yourself or for an eligible
dependent (including your spouse) while
other health insurance or group health
plan coverage is in effect, you may be
able to enroll yourself and your
dependents in this plan if you or your
dependents lose eligibility for that other
coverage (or if the employer stops
contributing toward the other coverage).
However, you must request enrollment
within 31 days after your or your
dependents' other coverage ends (or
after the employer stops contributing to
the other coverage.
Loss of Medicaid or SCHIP coverage:
If you decline enrollment for yourself or
for an eligible dependent (including your
spouse) while Medicaid coverage or
coverage under a state children's health
insurance program is in effect, you may
be able to enroll yourself and your
dependents in this plan if you or your
dependents lose eligibility for that other
coverage. However, you must request
enrollment within 60 days after you or
your dependents' coverage ends under
Medicaid or a state children's health
insurance program.
New dependent: If you have a new
dependent as a result of marriage, birth,
adoption, or placement for adoption, you
may be able to enroll yourself and your new
dependents. However, you must request
enrollment within 31 days after the
marriage, birth, adoption, or placement for
adoption.
Eligibility for Medicaid or SCHIP
premium assistance: If you or your
dependents (including your spouse)
become eligible for a state premium
assistance subsidy from Medicaid or
through a state children's health insurance
program with respect to coverage under
this plan, you may be able to enroll
yourself and your dependents in this plan.
However, you must request enrollment
within 60 days after your or your
dependents' determination of eligibility
for such assistance.
Medicaid and the Children’s
Health Insurance Program
(CHIP) Offer Free Or Low-
Cost Coverage
CHIP is short for the Children’s Health
Insurance Program—a program to
provide health insurance to all uninsured
children and who are not eligible for or
enrolled in Medical Assistance. CHIPRA is
the reauthorization act of CHIP which
was signed into law in February 2009.
Under CHIPRA, a state CHIP program
may elect to offer premium assistance to
subsidize employer-provided coverage
for eligible low-income children and
families. All employers are required to
provide employees notification regarding
CHIPRA.
Important Regulations
II │ 2019
Important Notice from The Guest Services About Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find
it. This notice has information about your current prescription
drug coverage with Capital Blue Cross and about your options
under Medicare’s prescription drug coverage. This information
can help you decide whether or not you want to join a Medicare
drug plan. If you are considering joining, you should compare
your current coverage, including which drugs are covered at
what cost, with the coverage and costs of the plans offering
Medicare prescription drug coverage in your area. Information
about where you can get help to make decisions about your
prescription drug coverage is at the end of this notice.
There are two important things you need to know about your
current coverage and Medicare’s prescription drug coverage:
1. Medicare prescription drug coverage became available in
2006
to everyone with Medicare. You can get this coverage if you
join
a Medicare Prescription Drug Plan or join a Medicare
Advantage
Plan (like an HMO or PPO) that offers prescription drug
coverage.
All Medicare drug plans provide at least a standard level of
coverage set by Medicare. Some plans may also offer more
coverage for a higher monthly premium.
2. Guest Services has determined that the prescription drug
coverage offered with the Kaiser HMO, CareFirst PPO and
CareFirst HDHP 1500 plans is, on average for all plan
participants, expected to pay out as much as standard
Medicare prescription drug coverage pays and is therefore
considered Creditable Coverage. Because your existing
coverage is Creditable Coverage, you can keep this coverage
and not pay a higher premium (a penalty) if you later decide
to join a Medicare drug plan.
When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible
for Medicare and each year from October 15 to December 7.
However, if you lose your current creditable prescription drug
coverage, through no fault of your own, you will also be eligible
for a two (2) month Special Enrollment Period (SEP) to join a
Medicare drug plan.
What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current Guest
Services coverage will not be affected. Part D eligible individuals
(or their dependents) can retain their existing coverage and
choose not to enroll in a part D plan; or, they can enroll in a part
D plan as a supplement to, or in lieu of the other coverage.
Finally, if the member’s existing prescription drug coverage is
with a Medigap policy, they cannot have both their existing
prescription drug coverage and part D coverage. See pages 7- 9
of the CMS Disclosure of Creditable Coverage To Medicare Part D
Eligible Individuals Guidance (available at http://
www.cms.hhs.gov/CreditableCoverage/), which outlines the
prescription drug
plan provisions/options that Medicare eligible individuals
may have available to them when they become eligible for
Medicare Part D. If you decide to join a join a Medicare drug plan
and drop your current Guest Services coverage, be aware that
you and your dependents will be able to get this coverage back
at Guest Services next open enrollment period.
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage
with Guest Services and don’t join a Medicare drug plan within 63
continuous days after your current coverage ends, you may pay a
higher premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable
prescription drug coverage, your monthly premium may go up by
at least 1% of the Medicare base beneficiary premium per month
for every month that you did not have that coverage. For
example, if you go nineteen months without creditable coverage,
your premium may consistently be at least 19% higher than the
Medicare base beneficiary premium. You may have to pay this
higher premium (a penalty) as long as you have Medicare
prescription drug coverage. In addition, you may have to wait
until the following November to join.
For More Information About This Notice Or Your Current Prescription Drug Coverage… Contact the person listed below for further information. NOTE:
You’ll get this notice each year. You will also get it before the next
period you can join a Medicare drug plan, and if this coverage
through Guest Services changes. You also may request a copy of
this notice at any time.
For More Information About Your Options Under Medicare Prescription Drug Coverage… More detailed information about Medicare plans that offer
prescription drug coverage is in the “Medicare & You” handbook.
You’ll get a copy of the handbook in the mail every year from
Medicare. You may also be contacted directly by Medicare drug
plans.
For more information about Medicare prescription drug coverage:
Visit www.medicare.gov
Call your State Health Insurance Assistance Program (see
the inside back cover of your copy of the “Medicare & You”
handbook for their telephone number) for personalized help
Call 1-800-MEDICARE (1-800-633-4227). TTY users should
call 1-877-486-2048.
If you have limited income and resources, extra help paying for
Medicare prescription drug coverage is available. For information
about this extra help, visit Social Security on the web at
www.socialsecurity.gov, or call them at 1-800-772-1213 , TTY 1-
800-325-0778).
Remember: Keep this Creditable Coverage notice. If you decide to
join one of the Medicare drug plans, you may be required to provide
a copy of this notice when you join to show whether or not you have
maintained creditable coverage and, therefore, whether or not you
are required to pay a higher premium (a penalty).
Date: October 2018
Name of Entity/Sender: Guest Services
Contact: Human Resources
Benefits Information Guide │ III
Health Insurance Portability and
Accountability Act (HIPAA) of
1996 Privacy Notice
This notice describes how medical information about you may
be used and disclosed and how you can get access to this in-
formation. Please read this notice carefully.
Guest Services benefit plans provide various welfare benefits,
including the following self-insured health care benefits: medi-
cal, dental, vision and Health Care Spending Accounts. These
self-insured health care benefits are collectively referred to
herein as the “Plan”. This notice describes the legal obligations
of the Plan under the Health Insurance Portability and Account-
ability Act of 1996 (HIPAA) and your legal rights regarding
your protected health information held by the Plan. Note: If
you receive insured medical benefits, you will receive a sepa-
rate Notice of Privacy Practices from the insurer with respect to
such insured benefits.
The Plan is required by federal law to maintain the privacy of
protected health information and to provide you with Notice of
the Plan’s duties and privacy practices. Protected health infor-
mation (“PHI”) means individually identifiable health infor-
mation that is created or received by the Plan that relates to:
your present, or future physical or mental health or condi-
tion;
the provision of health care to you; or
the past, present, or future payment for the provision of
health care to you.
Individually identifiable health information includes any infor-
mation, including demographic information, for which there is a
reasonable basis to believe the information can be used to
identify you. In general, the Plan receives and maintains
health information only as needed for claims or plan opera-
tions. The primary source of your health information is the
healthcare provider (for example, your doctor, dentist or hospi-
tal) that created the records.
The Plan is required to operate in accordance with the terms of
this Notice. The Plan reserves the right to change the terms of
this Notice. If there is a material change to the uses or disclo-
sures, your rights, the Plan’s legal duties or privacy practices,
the Notice will be revised and you will receive a copy of it. The
new provisions will apply to all protected health information the
Plan maintains, including information that existed prior to the
revision. This Notice was effective July 1, 2010.
The Plan may use and disclose your PHI without your
authorization or consent for purposes of treatment, pay-
ment and health care operations.
The Plan is permitted to use or disclose PHI without your con-
sent or authorization in order to carry out treatment, payment
or health care operations. Information about treatment in-
volves the care and services you receive from a health care
doctor or a hospital. Information about payment involves activi-
ties by the Plan to provide coverage and benefits.
Payment activities include determinations of eligibility, covered
services and claims payment. For example, claims are made for
services you receive from a doctor. Health care operations in-
clude activities of administration for the Plan and arranging for
outside services. For example, the Plan provides information to
an insurance company for the purpose of determining eligibility.
The Plan may contract with Business Employees to provide cer-
tain types of services. In order to perform those services, Busi-
ness Employees will receive, create, maintain, use and disclose
your PHI, but only after they agree in writing to implement ap-
propriate safeguards regarding your PHI. For example, the Plan
may disclose your PHI to a Business.
Employee to administer claims or to provide support services.
The Plan may contact you to provide information about treat-
ment alternatives or other health-related benefits that may be of
interest to you. The Plan may disclose health information to the
Plan sponsor if it is needed to carry out administrative functions
of the Plan.
The Plan may use or disclose your PHI for other purposes
without your written consent or authorization.
Your consent or authorization is not needed before the Plan dis-
closes your PHI for one or more of the following reasons:
For any purpose required by law, such as responding to a
court order.
For public health activities as authorized by law or to comply
with applicable law, such as reporting disease, injury, birth,
death, or public health surveillance, investigations and inter-
ventions.
To the proper government authorities if child abuse or ne-
glect is reported, or if the Plan reasonably believes an indi-
vidual is a victim of abuse, neglect or domestic violence.
To a health oversight agency for oversight authorized by
law for audits, investigations, proceedings and actions.
In the course of any judicial or administrative proceedings
(for example, responding to a subpoena or lawful request).
To a law enforcement official (for example, court order, war-
rant, subpoena or summons).
To a coroner or medical examiner or funeral director (for
example, to identify the deceased).
To facilitate organ, eye or tissue donation and transplanta-
tion.
For research purposes as permitted and provided for by law.
To avert a serious threat to health or safety of a person or
the public, if consistent with legal and ethical standards.
IV │ 2019
If required by law, to the Secretary of the Department of
Health and Human Services to investigate or determine the
Plan’s compliance with applicable law.
The Plan may use and disclose your PHI in cases not de-
scribed above only with your written authorization.
If you authorize a use or disclosure, you have the right to revoke
that authorization. Your decision to revoke an authorization must
be in writing, must be timely and delivered to the Guest Services
Chief Human Resources Officer. Your revocation of your authoriza-
tion will apply only to future disclosures of PHI. Once the Plan has
taken action in reliance on your authorization, the authorization
can no longer be revoked for PHI already released.
Your Rights with Respect to Protected Health Information
The privacy of health information that can be identified as infor-
mation about you is protected. Not all health information is pro-
tected. Health information that does not identify you or cannot be
used to identify you is not protected. You have the following
rights:
You have the right to request restrictions on certain uses and
disclosures of PHI about your. You may request a restriction
on the use or disclosure for the purposes of treatment, pay-
ment or health care operations. Your request must be in writ-
ing. The Plan is not required to agree to this restriction if it
would prevent the Plan from carrying out payment or health
care operations. Even is the Plan agrees, there are exceptions
to a restriction, for example, if you need emergency treat-
ment. There are certain uses and disclosures that cannot be
restricted. For example, if disclosure is required by law, a
restriction would not apply. You may terminate any restriction
that you have requested. The Plan may terminate any re-
striction it agreed to without your approval. A termination by
the Plan will affect only new information; that is, information
created or received by the Plan after the termination.
You have a right to receive confidential (alternative) communi-
cations of protected health information. You may request that
protected health information be communicated to you at an
alternative address or by alternative means if you clearly state
in your request that disclosure of all or part of protected
health information could endanger you. Your request must be
in writing. Your request must specify an alternative address
or other method of contact. The plan will accommodate rea-
sonable requests.
You have a right to inspect and copy certain protected health infor-
mation about you that is maintained by the Plan. Remember that
your healthcare provider has the most complete records of your
health care. The provider has health information about you that
the plan does not have, use or maintain. We recommend that you
contact your health care provider to review your health infor-
mation. If you want to see the information maintained by the
Plan, you must make the request in writing to the Guest Services
Chief Human Resources
Officer. The Plan may charge you a cost-based fee for
supplies, labor and postage. If you ask for a summary
or explanation of your PHI, the Plan may charge you for
the cost of preparing the summary or explanation. Your
right of access is limited. You do not have a right of
access to psychotherapy notes, or to information used in
judicial or administrative proceedings, or subject to the
federal Privacy Act, or under a promise of confidentiali-
ty.
You have a right to amend protected health information
about you that is maintained by the Plan. Your request
must be in writing and must give a reason for your re-
quest. Your right to amend is limited. You may only
amend information that is available to you under your
right of access. The Plan may deny your request if the
information was not created by the Plan and the creator
of the information is still available to respond to your
request. The Plan may deny your request if the infor-
mation is already accurate and complete.
You have a right to request and receive a paper copy of
this Notice. If you have agreed to receive this Notice by
e-mail, you have a right also to receive a paper copy
upon request.
You have a right to be notified if there is a breach re-
garding your PHI. The Plan must notify you of any un-
authorized use or disclosure of your PHI that violates
the HIPAA privacy rules and that poses a significant risk
of financial, reputational or other harm to you. The Plan
must notify you no later than 60 days after the breach is
discovered.
Complaints
You may complain to the Plan or to the Secretary of the U.S.
Department of Health and Human Services if you believe
your privacy rights have been violated. Complaints to the
Plan should be made to the Guest Services Chief Human
Resources Officer. Retaliation against a person who files a
complaint is prohibited.
Contacting the Plan About This Notice
For further information about the content of this notice or
about filing a complaint, you should contact your human
resource representative or call CareFirst at 1-800-853-9236
or Kaiser HMO at 1-800-556-7677
Benefits Information Guide │ V
If you or your children are eligible for
Medicaid or CHIP and you’re eligible for
health coverage from your employer, your
state may have a premium assistance
program that can help pay for coverage,
using funds from their Medicaid or CHIP
programs. If you or your children aren’t
eligible for Medicaid or CHIP, you won’t be
eligible for these premium assistance
programs but you may be able to buy
individual insurance coverage through the
Health Insurance Marketplace. For more
information, visit www.healthcare.gov.
If you or your dependents are already
enrolled in Medicaid or CHIP and you live in
a State listed below, contact your State
Medicaid or CHIP office to find out if premium
assistance is available.
If you or your dependents are NOT currently
enrolled in Medicaid or CHIP, and you think
you or any of your dependents might be
eligible for either of these programs, contact
your State Medicaid or CHIP office or dial
1-877-KIDS NOW or
www.insurekidsnow.gov to find out how
to apply. If you qualify, ask your state if it
has a program that might help you pay the
premiums for an employer-sponsored plan.
If you or your dependents are eligible for
premium assistance under Medicaid or CHIP,
as well as eligible under your employer plan,
your employer must allow you to enroll in
your employer plan if you aren’t already
enrolled. This is called a “special enrollment”
opportunity, and you must request
coverage within 60 days of being
determined eligible for premium
assistance. If you have questions about
enrolling in your employer plan, contact the
Department of Labor at
www.askebsa.dol.gov or call 1-866-444-
EBSA (3272).
If you live in one of the following states,
you may be eligible for assistance paying
your employer health plan premiums. The
following list of states is current as of July
31, 2018. Contact your State for more
information on eligibility –
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
ALABAMA – Medicaid IOWA – Medicaid
Website: http://myalhipp.com/
Phone: 1-855-692-5447
Website: http://dhs.iowa.gov/hawk-i
Phone: 1-800-257-8563
ALASKA – Medicaid KANSAS – Medicaid
The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861 Email: [email protected] Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx
Website: http://www.kdheks.gov/hcf/
Phone: 1-785-296-3512
KENTUCKY – Medicaid
Website: https://chfs.ky.gov
Phone: 1-800-635-2570
ARKANSAS – Medicaid LOUISIANA – Medicaid
Website: http://myarhipp.com/
Phone: 1-855-MyARHIPP (855-692-7447)
Website: http://dhh.louisiana.gov/index.cfm/subhome/1/n/331
Phone: 1-888-695-2447
COLORADO – Health First Colorado (Colorado’s Medicaid
Program) & Child Health Plan Plus (CHP+) MAINE – Medicaid
Website: http://www.maine.gov/dhhs/ofi/public-assistance/index.html
Phone: 1-800-442-6003
Health First Colorado Website: https://www.healthfirstcolorado.com/
Health First Colorado Member Contact Center:
1-800-221-3943/State Relay 711 CHP+: Colorado.gov/HCPF/Child-Health-Plan-Plus
CHP+ Customer Service: 1-800-359-1991/State Relay 711
MASSACHUSETTS – Medicaid and CHIP
Website: http://www.mass.gov/eohhs/gov/departments/masshealth
Phone: 1-800-862-4840
FLORIDA – Medicaid MINNESOTA – Medicaid
Website: http://flmedicaidtplrecovery.com/hipp/
Phone: 1-877-357-3268
Website: https://mn.gov/dhs/people-we-serve/seniors/health-care/health-care-programs/programs-and-services/other-insurance.jsp
Phone: 1-800-657-3739
GEORGIA – Medicaid MISSOURI – Medicaid
Website: http://dch.georgia.gov/medicaid
- Click on Health Insurance Premium Payment (HIPP)
Phone: 404-656-4507
Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm
Phone: 573-751-2005
INDIANA – Medicaid MONTANA – Medicaid
Healthy Indiana Plan for low-income adults 19-64 Website: http://www.in.gov/fssa/hip/
Phone: 1-877-438-4479
All other Medicaid Website: http://www.indianamedicaid.com
Phone 1-800-403-0864
Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP
Phone: 1-800-694-3084
VI │ 2019
U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565
To see if any other states have added a premium assistance program since July 31, 2018 , or for more information on special enrollment rights, contact either:
NEBRASKA – Medicaid SOUTH CAROLINA – Medicaid
Website: http://www.ACCESSNebraska.ne.gov
Phone: (855) 632-7633
Lincoln: (402) 473-7000 Omaha: (402) 595-1178
Website: https://www.scdhhs.gov
Phone: 1-888-549-0820
NEVADA – Medicaid SOUTH DAKOTA - Medicaid
Website: http://dhcfp.nv.gov/
Phone: 1-800-992-0900
Website: http://dss.sd.gov
Phone: 1-888-828-0059
NEW HAMPSHIRE – Medicaid TEXAS – Medicaid
Website: https://www.dhhs.nh.gov/ombp/nhhpp/
Phone: 603-271-5218
Hotline: NH Medicaid Service Center at 1-888-901-4999
Website: http://gethipptexas.com/
Phone: 1-800-440-0493
NEW JERSEY – Medicaid and CHIP UTAH – Medicaid and CHIP
Medicaid Website:
http://www.state.nj.us/humanservices/dmahs/clients/medicaid/
Medicaid Phone: 609-631-2392
CHIP Website: http://www.njfamilycare.org/index.html
CHIP Phone: 1-800-701-0710
Medicaid Website: https://medicaid.utah.gov/
CHIP Website: http://health.utah.gov/chip
Phone: 1-877-543-7669
NEW YORK – Medicaid VERMONT– Medicaid
Website: https://www.health.ny.gov/health_care/medicaid/
Phone: 1-800-541-2831
Website: http://www.greenmountaincare.org/
Phone: 1-800-250-8427
NORTH CAROLINA – Medicaid VIRGINIA – Medicaid and CHIP
Website: https://dma.ncdhhs.gov/
Phone: 919-855-4100 Medicaid Website: http://www.coverva.org/
programs_premium_assistance.cfm
Medicaid Phone: 1-800-432-5924
CHIP Website: http://www.coverva.org/
programs_premium_assistance.cfm
CHIP Phone: 1-855-242-8282
NORTH DAKOTA – Medicaid
Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/
Phone: 1-844-854-4825
OKLAHOMA – Medicaid and CHIP WASHINGTON – Medicaid
Website: http://www.insureoklahoma.org
Phone: 1-888-365-3742
Website: http://www.hca.wa.gov/free-or-low-cost-health-care/program
-administration/premium-payment-program
Phone: 1-800-562-3022 ext. 15473
OREGON – Medicaid WEST VIRGINIA – Medicaid
Website: http://healthcare.oregon.gov/Pages/index.aspx
http://www.oregonhealthcare.gov/index-es.html
Phone: 1-800-699-9075
Website: http://mywvhipp.com/
Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)
PENNSYLVANIA – Medicaid WISCONSIN – Medicaid and CHIP
Website: http://www.dhs.pa.gov/provider/medicalassistance/
healthinsurancepremiumpaymenthippprogram/index.htm
Phone: 1-800-692-7462
Website:
https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf
Phone: 1-800-362-3002
RHODE ISLAND – Medicaid WYOMING – Medicaid
Website: http://www.eohhs.ri.gov/
Phone: 855-697-4347
Website: https://wyequalitycare.acs-inc.com/
Phone: 307-777-7531
Benefits Information Guide │ VII
Health Care Reform Update
The Affordable Care Act (or ACA) continues to impact health insurance plans for employers like CRC. For the company, it means we continue to comply with all applicable health plan coverage and administration requirements and pay all applicable taxes and fees as required by the ACA.
However, 2019 will bring one significant change in how the ACA affects individuals. Since 2014, the law has required most individuals to have health insurance coverage or pay a tax penalty. Effective 2019, that tax will be eliminated, which means individuals who do not maintain health insurance coverage will no longer be penalized.
This change to the individual coverage requirement will not affect the availability of health care coverage options through the ACA Health Insurance Marketplace (www.healthcare.gov). Individuals will still have the ability to purchase coverage through the Marketplace and premium subsidies for that coverage will remain available to qualifying individuals.
As a reminder, CRC pays the majority of the cost for the health care coverage we offer to eligible employees. It’s also important to note that, because you are eligible for coverage through CRC, you may not qualify for premium subsidies if you choose to purchase a plan through the Marketplace. We encourage you to evaluate all your coverage options and compare their costs to make the best choice for you and your family.
3055 Prosperity Avenue, Fairfax, VA 22031 | (703) 849-9300
/guestservicesinc @[email protected]
This Team Member Benefits Enrollment Guide is being provided to you as a resource. It summarizes your 2019 team member benefits and coverage options. Please review this guide and all other available resources so you can make the best benefit decisions for you and your family.
This guide highlights the main features and/or provides a summary of Guest Services Team Member benefits. It does not include all plan details, rules, restrictions or limitations and should not be considered a substitute for the legal plan documents or Summary Plan Descriptions (SPD). The terms of your benefit plans are governed by the legal plan documents, including insurance contracts. Should there be any inconsistencies between this guide and the legal plan documents, the legal plan documents will govern. Guest Services, Inc. retains the right to modify or eliminate the plan benefits listed herein and any other benefits at any time for any reason.
