OPEN ENROLLMENT: October 21 - November 18, 2019
2020 Benefits Guide: October 2019 2
Employee Benefits
This Benefits Guide includes a notice regarding how the plan’s prescription drug coverage compares to Medicare Part D. If you or a covered family member is also enrolled in Medicare Parts A or B, but not Part D, you should read the Medicare Part D notice carefully.
It is titled, “Import Notice from American Furniture Warehouse about Your Prescription Drug Coverage and Medicare”.
Please note: This guide is intended to be informational and is subject to change by American Furniture Warehouse at any time.
ALL New Employees MUST waive or enroll online at my.AFW.net
2020 Benefits Guide: October 20193
Table of Contents 2020 Benefits Changes Overview.......................................................
New Employee Notice.........................................................................
Employee Benefits Overview............................................................... Medical Insurance Plans...................................................................... Dental Plans......................................................................................... Vision Plan............................................................................................ Flexible Spending Accounts................................................................ Group Employee Life and AD&D and Dependent Life Insurance...... Voluntary Life and AD&D, Spouse Life and Child Life Insurance....... AFLAC Supplemental Plans................................................................ Long Term Disability and Employee Assistance Program................. Employee 401(k) and ROTH 401(k) Savings Plans............................. Paid Time-Off Benefits......................................................................... Extra Perks........................................................................................... Important Contact Information............................................................ Medicare D Notice............................................................................... Marketplace Notice..............................................................................
Jake JabsPresident/CEOAmerican Furniture Warehouse
4 6 7 8 9 9 11 12 12 13 14 15 16 17 18 18 20
WORKLIFE PARTNERSHIP WORKLIFEPARTNERSHIP.ORG 17 / XX
WorkLife Navigators are Community Resource SpecialistsThe right expertise.
The right time.
The right place.
• Finding resources for affordable housing
• Connecting to legal resources
• Accessing reliable transportation
• Utility assistance
• Food resources
• Support in finding affordable child care options
• Household budgeting
• Navigate resources for debt management
Help with life. Help with finances.
• Reviewing health insurance policies & terms
• Choosing the right insurance
• Understanding benefits
• Managing medical bills
• Understanding Medicaid & Medicare
Help with health insurance.
2020 Benefits Guide: October 2019 4
Moving to a GROUP policy for:• ShortTermDisability• Hospital• CriticalIllness(ReplacesCancer)• Accident
What’s New:• Substantiallylowerpremiumsforalmosteveryone.• PremiumcostavailableduringopenenrollmentinOracle.
• Noqualificationquestions-peoplewhohavebeendeniedorhaveoptedoutinthepastcansignupwithoutanyquestions.• HospitalandAccidentpremiumswillbepre-tax.• Anyonewhowantstokeeptheirindividualpolicycankeepit.
All employees will receive a notice from AFLAC of the individual policy ending December 31, 2019.Tokeeptheindividualpolicy,contacttheAFLACrepresentative,JenniferFreeman.Contactinformationisonmy.afw.netandwillbeintheletter.EmployeespayAFLACdirectlyforindividualpolicies.Grouppoliciesareelectedduringopenenrollment.
We are going to eliminate the Kaiser 500 and Kaiser POS plan for 2020. IfemployeeswanttostaywithKaiser,theywillmovetothe1000plan.OurBenefitsTeamcanansweranyquestionsyoumighthaveaboutthetransition.Contactateammember:benefits@afwonline.comorseeafulllistofcontactsatmy.AFW.net.IfyouarecurrentlyenrolledinKaiser500orPOSandareconsideringAetna,thereisanoptiontocontinuecarewithyourcurrentproviderforcertaincircumstances.SeeamemberofHRformoreinformationandtoobtainaTransitionofCoverage(TOC)form.TheTOCformappliestonewAetnamembersthatareamidtreatment(e.g.thirdtrimesterofpregnancy,chemotherapy,radiation,etc.)andtheirtreatingproviderisNOTintheAetnanetwork.Theapplicationmustbesubmittedforreviewandapproval.Ifapproved,themembermaycontinuetogetservicesfromtheout-of-networkprovideratthein-networklevelforalimitedamountoftime.
Youcantalktoadoctor24/7.Getprescriptions,etc.with$0outofpocketfor:MinuteClinicsorTeleDoc.
Dental & Vision. Therearenowfourtiersofdentalandvisioninsurancerates.• Employee• Employee+Spouse• Employee+Child(ren)• Employee+Family
Wellness. Earnapremiumdiscountforcompletingyourannualphysical.Whenanemployeeorcoveredspousecompleteshisorherannualpreventativecarephysical,theywillreceivea$10permonthpremiumdiscount.Thephysicianwillcompleteaformindicatingonlythattheemployeeorspousehascompletedaphysical.TheemployeeuploadstheformtoOracleoremailstobenefits@afwonline.com.Blankformsareavailablefordownloadatmy.AFW.netorTIGERunderHumanResources.
The ZeroCard. ThisbenefitisonlyavailableonlytoAetnasubscribers.Healthcarecanbeconfusingandexpensive-that’swhyZeroCardishere!Forhundredsofserviceslikesurgery,lab,imagingandevenprescriptions,ZeroCardcangetyouthecareyouneed,forabsolutelyZEROcosttoyou.Aetnasubscribersareautomaticallyenrolledfor2020.TheZeroCardisanetworkontopoftheAetnanetwork.Ifyouelecttohaveaprocedureorgetyourmailorderpharmacythroughtheirservice,thereisnooutofpocketcoststothemember.Youcanviewnetworksatthezerocard.com.
2020 Benefits Changes OverviewIn 2020, we will transition to a group policy with AFLAC. This will extend many benefits to you:
WORKLIFE PARTNERSHIP WORKLIFEPARTNERSHIP.ORG 17 / XX
WorkLife Navigators are Community Resource SpecialistsThe right expertise.
The right time.
The right place.
• Finding resources for affordable housing
• Connecting to legal resources
• Accessing reliable transportation
• Utility assistance
• Food resources
• Support in finding affordable child care options
• Household budgeting
• Navigate resources for debt management
Help with life. Help with finances.
• Reviewing health insurance policies & terms
• Choosing the right insurance
• Understanding benefits
• Managing medical bills
• Understanding Medicaid & Medicare
Help with health insurance.
A company’s employees are its most valuable assets.
We want to help them succeed.
WorkLife doesn’t just help you find a solution.
WorkLife helps you navigate the solution.
Connect with us today.
Services are one-on-one
Always confidential
Mobile
Free
www.worklifeparternship.org
Text AFWNav to 555888
or email
to connect to a Navigator today.
2020 Benefits Guide: October 20195
Worklife navigators are available to all employees and their families at no cost.
AFW Navigator
Derek Von Schulz303-880-5925AllLocations
2020 Benefits Guide: October 2019 6
New Employees Notice
Important for New EmployeesEnrollorwaivecoverageandchooseyourbeneficiariesbyyour60thcalendardayofemployment.Theenrollmentwindowclosesonthe60thcalendardayandyourelectionsareeffectivethe1stdayofthemonth,following60daysofemployment. Where to Enroll or Waive
1. Visithttp://my.afw.net.2. LogintoOracle.
3. LookfortheBenefitsPackage.
4. Lookforthedarkbluebuttonthatsays“Start Enrollment”.5. Makeyourelections.6. Remembertosubmitandprintyourelectionchoices.
Questions? Atanytime,youcancontactamemberoftheHRteam.Afulllistofcurrentcontactsisavailableatmy.afw.net/Benefitscontactsarealsolistedthroughoutthisguide.
OPEN ENROLLMENT: October 21 -
November 18, 2019
2020 Benefits Guide: October 20197
Employee Benefits Overview BenefitsareanintegralpartoftheoverallcompensationpackageprovidedbyAmericanFurnitureWarehouse(AFW).WithinthisBenefitsGuideyouwillfindimportantinformationonthebenefitsavailabletoyouforthe2020calendaryear.PleasetakeamomenttoreviewthebenefitsAFWofferstodeterminewhichplansarebestforyou.
Benefits EligibilityYouareeligibletoparticipateintheAFWBenefitPlansifyouarefull-timeorworkonaverage30hoursperweekormore.Elected Benefit Plans are effective the first of the month following 60 days of employment. Manyoftheplansoffercoverageforeligibledependents,including:
• Yourlegallymarriedspouse• Yourchildrenundertheageof26,regardlessofstudent,marital,ortax-dependentstatus(including astepchild,legallyadoptedchild,achildplacedwithyouforadoption,orachildforwhomyouare thelegalguardian).• Yourdependentchildrenofanyagewhoarephysicallyormentallyunabletocareforthemselves.
Enrollment: Visit my.AFW.netYoucansignupforbenefitsorchangeyourbenefitelectionsatthefollowingtimes:
• Withinyourfirst60daysofemployment.• DuringtheannualOpenEnrollmentperiod(October/Novemberofeachyear).• Within30daysofexperiencingaqualifyinglifeeventthathappenedtoyou,oraneligibledependent.
New Hire Enrollment TheelectionyoumakeatthistimewillremainthesamethroughDecember31,2019.If you do not sign up for benefits during your initial eligibility period, or during the open enrollment period, you will not be able to elect coverage until the following plan year, unless you, or an eligible dependent, experience a qualifying life event.
Changing Your Benefits During the YearDuetoIRSregulations,onceyouhavemadeyourelectionsfortheplanyear,youcannotchangeyourbenefitsuntilthenextannualopenenrollmentperiod.Theonlyexceptionisifyou,oraneligibledependent,experienceaqualifyinglifeeventandyoumakechangeswithin30daysofthelifeevent.Electionchangesmustbeconsistentwithyourlifeevent.
Torequestabenefitschange,gotomy.AFW.net.Qualifyinglifeeventsinclude,butarenotlimitedto:
• Marriage,divorceorlegalseparation.• Birthoradoptionofaneligiblechild.• Deathofyourspouseorcoveredchild.• Changeinyourspouse’sworkstatusthataffectstheirbenefits.• Changeinyourchild’seligibilityforbenefits.• Qualifiedmedialchildsupportorder.
HR Contacts for BenefitsBeverlyZimmerman–BenefitsManager–[email protected]–HumanResourceGeneralist–[email protected]
2020 Benefits Guide: October 2019 8
Medical Insurance PlansAmericanFurnitureWarehouseofferstwomedicaloptions.Acomparisonchartisbelowandmoreinformationcanbefoundatwww.aetna.comorwww.kp.org.Pleasenote:Theinformationprovidedbelowisbasedonin-networkservices.Out-of-networkbenefitsarenotshownbelow.Pleaserefertothesummaryplandescriptionfordetails.
Amedicalcardwillbeissuedonceelectedbenefitsgointoeffect.SummaryPlanDescriptions(SPD)areavailabletodownloadviatheOracleenrollmentpage.Or,youcangetthembycontactingamemberoftheBenefitsTeam.Currentcontactinformationisavailableathttp://my.AFW.net.
Summary of Covered Benefits
Aetna Choice POS II $500 Aetna Choice POS II $1,000
Kaiser DHMO $1,000
Plan Year Deductible (Individual/Family)
$500 Individual $1,500 Family
$1,00 Individual $2,000 Family
$1,000 Individual $3,000 Family
Out-Of-Pocket Maximum (Individual/Family)
$3,500 Individual $7,000 Family
$3,000 Individual $6,000 Family
$3,000 Individual $6,000 Family
Preventative Care Covered 100% Covered 100% Covered 100%
Physician Services Primary Care Specialist Urgent Care
$20 Copay $30 Copay 10% Co-Insurance
$25 Copay $45 Copay 20% Co-Insurance
$25 Copay $45 Copay $45 Copay + 20% Co-Insurance
Lab / X-Ray Diagnostic Lab / X-Ray High-Tech Services (MRI, CT, PET)
No charge for laboratory; 10% Co-insurance for all others after deductible
No charge for laboratory; 20% Co-insurance for all others after deductible
No charge for laboratory; 20% Co-insurance for all others after deductible
Hospital Services Inpatient / Outpatient
10% Co-insurance after deductible
20% Co-insurance after deductible
20% Co-insurance after deductible
Emergency Room $200 Copay then 10% Co-insurance
$200 Copay then 20% Co-in-surance
20% Co-insurance after deductible
Prescription Drugs Generic Preferred Brand Non-Preferred Brand Specialty Mail Order (Up to 90 day supply)
Retail / Mail Order$10 / $20$30 / $60$60 / $120
Retail / Mail Order$10 / $20$30 / $60$60 / $120
Retail / Mail Order$10 / $20$30 / $60Not Covered
Monthly Premium Employee Only Employee + Children Employee + Spouse Employee + Family
$184.43$350.18$405.25$638.07
$101.79$251.33$314.02$483.11
$101.79$251.33$314.02$483.11
HealthReformLawIndividualMandate–Thegovernmentrequiresyouandyourfamilymemberstohavehealthinsurance.TheAmericanFurnitureWarehousemedicalplansmeetallofthehealthreformlawrequirementstosatisfytheIndividualmandate.
NEW FOR 2020:
$0 co-pay Teledoc, Minute Clinics.
--------------------
No out-of-pocket when you use Zero
Card.
--------------------
(Aetna enrollees only)
2020 Benefits Guide: October 20199
Dental Insurance PlansAmericanFurnitureWarehouseofferstwodentalplansadministeredbyDeltaDentalofColorado.Thechartbelowsummarizesthekeyfeaturesoftheplans,pleaserefertotheSummaryPlanDescriptionformoredetails.Alsovisitwww.deltadentalco.comforadditionalinformationandtofindanin-networkdentalofficeinyourarea,orcontactDeltaDentalofColoradoCustomerRelationsat1-800-610-0201.
DeltaDentalofColoradodoesnotissueabenefitcard.Toutilizetheelectedbenefits,visitwww.deltadentalco.comtofindanetworkdentist.Theproviderwillrequestyourpresonalinformationtoverifycoverage.
Summary of Covered Benefits Delta Dental PPO Only Plan Delta Dental PPO + Premier Plan
Calendar Year Maximum $2,000 per member $1,500 per member
Calendar Year Deductible None $50 Individual / $150 Family
Diagnostic and Preventative Services with various limitations (oral exams, cleanings, sealants, x-rays, fluoride, space maintainers)
100% 100%
Basic Services with various limitations (fillings, simple extractions, oral surgery endodontics/periodontics)
70% 80%
Major Services with various limitations (crowns, implants, dentures, bridges)
50% 50%
Orthodontics for covered adults and children $2,000 lifetime maximum covered at 50%
$1,500 lifetime maximum covered at 50%
Monthly Premium Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
$5.00
$18.16 $19.55 $44.40
$22.62 $50.10 $54.23 $97.33
Vision Insurance PlansAmericanFurnitureWarehouseoffersavisionplanadministeredbyVisionServicePlan(VSP).Youhavethefreedomtochooseanyvisionprovider.However,youwillmaximizetheplanbenefitswhenyouchooseanetworkprovider.LocateaVSPNetworkprovideratwww.vsp.comorcallmemberservicesat1-800-877-7195.
Thetable(onthenextpage)summarizesthekeyfeaturesofthevisionplanbasedonseekingservicesatanin-networkprovider.Inaddition,tothebelowbenefits,VSPproviderswillprovidea20%discountonlensoptionssuchasscratch-resistantandanti-reflectivecoatings,additionalpairsofglasses,andsunglasses.
Continuedonnextpagewithcoverageexplanation.
2020 Benefits Guide: October 2019 10
Benefit Description Copay FrequencyYour Coverage with a VSP Provider
WellVision Exam Focuses on your eyes and overall wellness $10 Every calendar year
Prescription Glasses $25 See frame and lenses
Frame • $170 allowance for a wide selection of frames• $190 allowance for featured frame brands• $20 savings on the amount over your allowance• $95 Costco® frame allowance
Included in Prescription Glasses
Every other calendar year
Lenses • Single vision, lined bifocal, and lined trifocal lenses• Polycarbonate lenses for dependent children
Included in Prescription Glasses Every calendar year
Lens Enhancements • Standard progressive lenses• Premium progressive lenses• Custom progressive lenses• Average savings of 20-25% on other lens enhancements
$0 $95 - $105
$150 - $175 Every calendar year
Contacts (instead of glasses)
• $170 allowance for contacts; copay does not apply• Contact lens exam (fitting and evaluation)
Up to $60 Every calendar year
Diabetic Eyecare Plus Program
• Services related to diabetic eye disease, glaucoma and age-related macular degeneration (AMD). Retinal screening for eligible members with diabetes. Limitations and coordination with medical coverage may apply. Ask your VSP doctor for details.
$20 As needed
Extra Savings
Glasses and Sunglasses• Extra $20 to spend on featured frame brands. Go to vsp.com/specialoffers for details.• 20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12 months of your last WellVision Exam.Retinal Screening• No more than a $39 copay on routine retinal screening as an enhancement to a Wellness Exam.Laser Vision Correction• Average 15% off the regular price or 5% off the promotional price; discounts only availabile from contracted facilities.
Your Coverage with Out-Of-Network Providers
Monthly PremiumEmployee Only $5.30
Employee + Child(ren) $10.95
Employee + Spouse $11.00
Employee + Family $18.70
Get the most out of your benefits and greater savings with a VSP network doctor. Call Member Services for out-of-network plan details.
2020 Benefits Guide: October 201911
Flexible Spending AccountsAFlexibleSpendingAccount(FSA)allowsindividualstousepre-taxdollarstopayforcertainexpensestaxfree.BelowisabriefsummaryofhowtheFSAaccountswork.Formoreinformationandcompleteaccountdetailspleasevisitwww.rockymountainreserve.com,orcall1-888-722-1223.Healthcare Flexible Spending AmountTheHealthcareFSAallowsyoutosetasidemoneyfromyourpaycheckonapre-taxbasis(beforeincometaxesarewithheld)topayforeligibleout-of-pocketexpenses,suchasdeductibles,copays,andotherhealth,dental,orvisionrelatedexpensesthatarenotpaidbyinsuranceplans.Thisincludesexpensesforyouoryoureligibledependents.The2020annualIRSlimitis$2,700.
Adebitcardisissuedforthosethatelectthisaccount,withthefullavailableelectedbalancethatcanbespentassoonasyourbenefitsareeffective.Receiptsandclaimformscanalsobesubmittedforreimbursement.KeepallreceiptsintheeventRockyMountainReserverequiresyoutoverifytheeligibilityofapurchase.
FSA Considerations Health Care Dependent CareWhat can I use it for? Your or your dependents’ out-of-pocket ex-
penses (medical, prescription drug, dental and vision deductibles, coinsurance and copays).
Child care for your tax dependent child(ren) under age 13, and elder care provided inside or outside your home (it cannot be used for medical, RX, dental or vision expenses).
Does it offer tax-free reimbursement? Yes Yes
How much can I contribute? You can contribute between $150 and $2700 per year.
You can contribute betwen $150 and $5,000 per year ($2,500 if married and filing separate-ly).
Does the balance roll over to the next year?
No, you must use the money in your account by December 31, 2019* or you lose it per the IRS guidelines, up to $500 is elgible.
No, yoju must you the money in your account by December 31, 2019 or you lose it per the IRS guidelines.
Do I get a debit card? Yes, you will receive two debit cards when you sign up for an FSA. If you re-enrollin an FSA for 2019, you will only get new cards if your current cards expire in 2019.
Yes, you will receive two debit cards when you sign up for an FSA. If you re-enrollin an FSA for 2019, you will only get new cards if your current cards expire in 2019.
Can I enroll in an FSA if I am also enrolled in the HRA plan?
Yes, but your card is limited to non-medical expenses. You cannot be reimbursed for the same expense out of both accounts (FSA and HRA).**
Yes, but remember the Dependent Care FSA is only for the child and elder care.
* You must use the money in your account by December 31, 2020, but you have until March 31, 2021, to submit your 2020 claims manually, if needed.
2020 Benefits Guide: October 2019 12
Dependent Daycare Flexible Spending Account TheDependentDaycareFSAallowsyoutosetasidemoneyfromyourpaycheckonapre-taxbasis(beforeincometaxesarewithheld)topayforeligibleout-of-pocketdependentdaycareexpenses.Eligibledependentsarechildrenunder13yearsofage,orachildover13,spouse,orelderlyparentresidinginyourhousewhoisphysicallyormentallyunabletocareforthemselves.Examplesofeligibleexpensesaredaycarefacilityfees,before-and-afterschoolcare,andin-homebabysittingfees(incomemustbereportedbyyourcareprovider).
The 2020 annual IRS limit is $5,000 if you are married and filing a joint return or if you file single or head of household.Ifyouaremarriedandfileseparatereturns,youcaneachelect$2,500forthe2020planyear.ThisFSAhasauseitorloseitrule.Meaning,ifyousignupfor$1,000andonlyspend$200byDecember31,oftheremainingavailablebalance$800youwillloseall$800.Receiptsandclaimformsmustbesubmittedforreimbursement.Thereimbursableamountisuptotheamountcontributedtotheaccountatthetimeofreimbursement.DependentcareexpensesreimbursedbythedependentdaycareFSAmaynotbeusedtoclaimthedaycarecreditonyourannualtaxreturn.
Group Employee Life and AD&D and Dependent Life Insurance AFWknowsLifeandAccidentalDeath&Dismemberment(AD&D)insuranceisanimportantelementofyourincomeprotectionplanning,especiallyforthosewhodependonyouforfinancialsecurity.Becauseofthis,AFWautomaticallyprovideseveryeligibleemployeeaGroupEmployeeLifeInsuranceandAD&DPlanthroughtheadministrator,Unum,freeofcharge.Ifyoudieasaresultofanaccident,yourbeneficiarywouldreceiveboththelifebenefitandtheAD&Dbenefit.You will be required to designate a beneficiary for this plan during your enrollment. Please be sure to keep your beneficiary designations up to date. Voluntary Employee Life and AD&D and Spouse Life Insurance AmericanFurnitureWarehouseprovidesadditionalvoluntarylifeinsuranceoptionsforyoutopurchaseforyourself,spouse,andyourdependentchildrenthroughUnum.Youmustpurchaselifeinsuranceforyourselfinordertopurchasecoverageforyourspouse.Youmayelect,inincrementsof$10,000,upto5Xyoursalarywithaguaranteeamountof$200,000duringyourNewHireEnrollment.Ifelected,youmayalsoelectlifeinsuranceforyourspouse,inincrementsof$10,000,uptoorequaltotheamountofcoverageonyourself,withaguaranteeamountof$50,000(NewHireEnrollmentonly).Benefitswillreduceto67%atage65,andto34%atage70.Enrollment into these plans outside of your New Hire Enrollment may require an Evidence of Insurability form to be completed, and will be the approval from Unum.
Premiumsfortheseplansvarybasedonageandtobaccousage,whichcanbefoundduringyourenrollment.Voluntary Child Life Insurance Inaddition,youmayalsoelectadditionallifeinsuranceforyourchildren,undertheageof26.Thevoluntarychildlifeinsuranceplancanbeelectedinincrementsof$2,000upto$10,000max.Theweeklypremiumforthisplanis$0.07per$2,000worthofcoverage.
Group Employee Life and AD&D
Employee Life $15,000 (Reduced to 67% at age 65, 34% at age 70)
AD&D $15,000 (Reduced to 67% at age 65, 34% at age 70)
2020 Benefits Guide: October 201913
Aflac Supplemental Insurance Plans
• Aflacisdifferentfromhealthinsurance.Itpayscashbenefitsdirectlytoyou.• Aflacbecomesyourfirst dollar responsetooutofpocketmedicalcoststhathealthinsurancepasseson toyoulikecopays,deductiblesandco-insurance.• Aflacisameasureoffinancialprotection:Incomeprotection,medicalexpensecoverage,andexpenses fordailyliving.• Evenifyoudon’thavehealthinsuranceyoucanstillparticipateinAflac.Thisisalsotrueforyour dependents.• Youhavetheconvenienceofpayrolldeductionatdiscountedgroup-rates.• NomatterhowmanyclaimsyoufileorhowlongyoukeepAflac,yourrateswillNOTbeincreased.• Aflac’sGroupClaimspayinlessthanthreedaysoncedocumentsarereceived.• Inaddition,thereisnotimelimitonfilingclaims.Short-term Disability-Protectyourbiggestassetthatpaysforeverything:yourpaycheck.• Coveragestartsfirstdayforoff-the-jobinjuries&after7-daysforillness/maternity.• 3-monthbenefitplans.Youarecoveredformissingworkupto3months.
Aflac Hospital Policy-Coverageforillness,injury,wellnessvisits,andmaternity.• Hospitalizationadmission$1000;hospitalconfinement$150.00/day.• Surgicalbenefitsforinpatientupto$500andoutpatientsurgeries:Upto$250persurgery.Anesthesia benefits.Benefitsthatpayfordoctor’sofficesurgeries.• DoctorVisitbenefits$25(6visits).• TelemedicineandChiropracticvisitsalsoincluded.
Accident Policy-Injurycoverage24/7,on&offthejob:• Initialdoctorvisitduetoaninjuryupto$150.• Initialurgentcareoremergencyroomvisitduetoaninjuryupto$250.• Followupvisitsduetoaninjury$50,Physicaltherapyvisitsduetoaninjury$50.Painmanagement$100.• Firstdayinthehospitalduetoaninjury$1,250.$300.00eachadditionalnight.• Additionalbenefits:Ligamentdamage,torncartilage,coma,concussion,fracturebenefit,sutures,brain injuries,burns,eyeinjuries,dentalinjuries,surgeriesforanaccidentandmanymore.• Wellnessbenefitonceperyearforroutinewellnesscheck-ups$25-$75.
Critical Illness with Cancer Policy.Cancer,heartattack,cardiacarrest,stroke,by-passsurgery,renalfailure,carcinomainsituupto$30,000incoverage.• Guaranteeissueregardlessofpreexistingconditionsofupto$30,000incoverage.• Spouseiseligibletomatchamountanemployeeelects.• Non-invasivecancerandskincancerbenefitsavailable.• Re-occurrencebenefitandadditionaloccurrencebenefit:Paysifthereisare-occurrenceofthesame qualifyingeventinsixormoremonths.• $50.00wellnessbenefitforemployee&spouseannually.
Aflac Group: 303-963-5775 or 1-800-433-3036 www.aflacgroupinsurance.comCustomer Service Center: [email protected]
*Theaboveoverviewisforillustrationpurposesonly.Forspecificdetailsrefertotheproductbrochures.
Remember if you wish to keep your individual Aflac Supplemental Insurance Plans, you must contact Jennifer Freeman at 303-963-5775, prior to December 31, 2019. Intheeventofyouremploymentending,thesebenefitswillendthedayinwhichyouremploymentends.
2020 Benefits Guide: October 2019 14
Long-Term Disability and Employee Assistance Program UnumistheadministratorofourLong-TermDisabilityPlanandourEmployeeAssistanceProgram(EAP)inadditiontotheLifeInsurancePlansmentionedpreviously.
Long-Term Disability InsuranceMuchlikeShort-TermDisability,Long-TermDisabilityisanincomesupplementthatwillcompensateyouintheeventyoubecomedisabledandunabletowork.Thedifferencebetweenthetwoistheperiodinwhichitprovidesabenefit.Short-TermDisabilityisforthefirst90daysyouareunabletowork.CompensationforaclaimapprovedforLong-TermDisabilitywon’tbereceivedunlessyouareunabletoworkmorethan90days.Ifelected,thepremiumisbasedonyourageandsalary,whichwillautomaticallyadjustwithageorsalaryincreases.Atthetimeofreceivingthebenefit,60%ofyourmonthlyearningwouldbepayableuponapprovalofyourclaimbyUnum,upto$5,000monthly.Thepaymentwillcontinueupto5yearsortoage70,whichevercomesfirst.Ifyouareoverage70atthetimeofyourclaim,thepaymentispayablefor1year.Belowisachartshowingthemonthlyrate.Duringyourenrollmentyouwillgetspecificrateinformationbasedonyourcurrentageandsalary.Intheeventofyouremploymentending,thesebenefitswillendyourlastdayofemployment.
Long-Term Disability RatesPer $100 of Covered Salary
Age Monthly Rate
<25 $0.14
25-29 $0.14
30-34 $0.18
35-39 $0.26
40-44 $0.32
45-49 $0.60
50-54 $0.91
55-59 $1.63
60-64 $2.50
65-69 $1.97
70-74 $0.76
75+ $0.83
2020 Benefits Guide: October 201915
Employee Assistance Program (EAP) All employees are eligible for the EAPWhenyouthinkofanEmployeeAssistanceProgram(EAP),youprobablythinkofcounselingandtherapy.Unum’sEAPismuchmorethanthat!Ofcourse,theyoffercounselingandtherapysessions,buttheyalsohavetools,resources,andwebinarsforyournormaleverydaystruggles.Including,budgeting,betterhealth,estateplanning,abuse,addition,stress,interpersonalskills,leadership,medicalbillsaver,legalsituations,taxesandretirement,justtonameafew.AsanAmericanFurnitureWarehouseemployee,youareeligibleforthisbenefiteffectiveyourhiredate.Notonlycanyoutakeadvantageofsomeverygoodinformationandhelp,socaneveryoneinyourhousehold.Thisisavailableonthe1stdayofemployment,regardlessofotherbenefitelections.
Youcanseekservicesbyvisitingwww.unum.com/lifebalanceorcall1-800-854-1446.American Furniture Warehouse 401(k) and Roth 401(k) Everyonewantstoretiresomeday,andAmericanFurnitureWarehouse(AFW)isproudtoofferyoua401(k)plantohelpprepareyouforyourretirement!Weoffertwodifferenttypesof401(k)accounts.Traditional401(k)whichisapre-taxdeductionandRoth401(k)whichisapost-taxdeduction.TheplansareadministeredbyFidelityInvestments.
Fidelity Investments (Administrator) – 1-800-294-4015 or visit www.netbenefits.comSpencer Olson (Free AFW Employee Financial Advisor) – 970-304-4909
Beverly Zimmerman (Benefits Manager) – 720-873-8611 Key Highlights
• When am I eligible? YouwillbeeligibleeitherJanuary1orJuly1following6monthsofemployment,whichevercomesfirst.Afteryouworkhere6months,youwillauto-enrollJanuary1storJuly1st.
• How do I enroll?TheAFW401(k)Planhasanauto-enrollfeature.Meaning,onceyouareeligibletoparticipateintheplan,youwillbeautomaticallyenrolledwitha3%contribution.Ifyouchoosetooptoutoftheplan,youmustcontactFidelityat1-800-294-4015tochangeyourcontributiontozero.
• When can I access my money?Youcanaccessyourmoneyattheageof59½withoutpenalty.Ifyoufindyourselfinahardship,therearetwoopportunitiestoaccessyourfunds,aloanorahardshipwithdrawal.BothoptionsrequireapprovalbyFidelityandmayresultinsignificanttaxpenalties.
• What happens to my money if I quit?Atthetimeoftermination,yourfundswillbeaccessibletoroll-overintoanother401(k)plan,cash-out(mayresultinpenalties),ordependingontheamountofyouraccountcanremainintheAmericanFurnitureWarehouse401(k)accountuntilyouretire.
• What happens to my money if I die?PleasebesuretoleaveabeneficiaryonfilewithFidelitybyvisitingwww.netbenefits.comsoyourmoneyhelpsthelovedonesofyourchoice.
2020 Benefits Guide: October 2019 16
Paid Time-Off Benefits AmericanFurnitureWarehouserecognizesthatlifehappens,andoffersavarietyofgeneroustime-offbenefits.Thesebenefitsincludevacationhours,sickhours,personaldays,holidaypay,andbereavementpay.AllscheduledtimeoffissubjecttoManagerapprovalandisbasedonbusinessneeds.
Vacation Hours Onyour90thdayofemployment,youwillbeawarded9.24hoursofvacation,andthenbeginaccruing0.77hoursofvacationperweekuntilyourone-yearanniversary.Thereafter,vacationhourswillbeaccruedat1.54hoursperweek.(Cappedat400hoursmaximum.)Earnedvacationhoursare
payableuponterminationofemployment.Sick Hours Sickhoursareearnedstartingonyourdateofhireat1.35hoursperweek.Themaximumamountofsickhoursthatcanbeaccruedis320.Anysickpayhoursaccruedover160hourscanbecashedoutorusedasvacationhours.Sick hours are not payable upon termination of employment.Personal Days Twopersonaldays(8hourseach)areearnedafter60daysofemploymentandthereaftereachJanuary1st.Personaldaysmustbeusedbythedayandnotpayablebythehour.Personaldaysmustbeusedwithinthecalendaryeartheyareearned.Personaldaysdonotrolloverandandarenotpayableuponterminationofemployment.HolidaysEaster,MemorialDay,LaborDay,ThanksgivingDay,andChristmasDayaredesignatedholidays.Holidaypayvariesbasedonyourposition.Pleasetalktoyourmanagerfordetails.Bereavement Benefit Bereavementbenefitsareforthepurposeofattendingfuneralservicesofalovedonecoveredunderthepolicy.Funeralpayistoprovideincomereplacmentforscheduledworkdaysactuallymissedtoattendfuneralormemorialservicesforfamilymembers.Documentationisrequired.(Employeesonaleaveofabsencearenoteligibleforbereavement.)
ImmediateFamilyMembers:Intheeventofthedeathofanimmediatefamilymember,anemployeeshall,uponrequest,begrantedsuchtimeoffwithpaynottoexceedfive(5)workingdays.Immediatefamilymembersinclude:
1. Spouse2. Parent3. Child
CloseFamilyMembers:Intheeventofthedeathofaclosefamilymember,anemployeeshall,uponrequest,begrantedsuchtimeoffwithpaynottoexceedthree(3)workingdays.Closefamilymembersinclude:
1. Sibling2. Mother/Father-in-law3. Stepchild4. Stepparent5. Grandchild6. Grandparents
2020 Benefits Guide: October 201917
Extra Perks• VasaFitnessGymMembership–ContactBeverlyorNancyfordetails
• 25%tuitionsavingsatDevryUniversityforemployeeandfamily–ContactDevryat1-866-606-8349for details.
• Discountedticketsandvariousothergreatdealsatwww.ticketsatwork.com(CompanyCode:afwonline).
• Discounteddailypassesandannualpassestoamusementparks.
• Reducedpricesonvarioussportstickets.
• Specialemployeepricingonmattresses.
• EmployeediscountswithVerizonWirelessandT-Mobile.Leaving us?Shouldyouremploymentend,medical,dental,visionandFSAbenefitsendattheendofthecalendarmonthofyourseparationdate.
IfyouhaveFSAbenefitsandhavequestionsaboutusingyourFSAafterseparationofemployment,contactRockyMountainReserveat888-722-1223oraBenefitsTeamMember.
2020 Benefits Guide: October 2019 18
Medicare D Notice Important Notice from American Furniture Warehouse About Your Prescription Drug Coverage and Medicare
Pleasereadthisnoticecarefullyandkeepitwhereyoucanfindit.ThisnoticehasinformationaboutyourcurrentoptionalprescriptiondrugcoveragewithAmericanFurnitureWarehouseandaboutyouroptionsunderMedicare’sprescriptiondrugcoverage.ThisinformationcanhelpyoudecidewhetherornotyouwanttojoinaMedicaredrugplan.
Ifyouareconsideringjoining,youshouldcompareyourcurrentcoverage,includingwhichdrugsarecoveredatwhatcost,withthecoverageandcostsoftheplansofferingMedicareprescriptiondrugcoverageinyourarea.
Informationaboutwhereyoucangethelptomakedecisionsaboutyourprescriptiondrugcoverageisattheendofthisnotice.TherearetwoimportantthingsyouneedtoknowaboutyourcurrentcoverageandMedicare’sprescriptiondrugcoverage:
1.Medicareprescriptiondrugcoveragebecameavailablein2006toEveryonewithMedicare.YoucangetthiscoverageifyoujoinaMedicarePrescriptionDrugPlanorjoinaMedicareAdvantagePlan(likeanHMOorPPO)thatoffersprescriptiondrugcoverage.AllMedicaredrugplansprovideatleastastandardlevelofcoveragesetbyMedicare.Someplansmayalsooffermorecoverageforahighermonthlypremium.
2.AmericanFurnitureWarehousehasdeterminedthattheprescriptiondrugcoverageofferedbytheAmericanFurnitureWarehousePlanis,onaverageforallplanparticipants,expectedtopayoutasmuchasstandardMedicareprescriptiondrugcoveragepays,andisthereforeconsideredCreditableCoverage.IfyouhaveelectedtheAmericanFurnitureWarehouseprescriptiondrugcoverage,yourexistingcoverageisCreditableCoverage.Youcankeepthiscoverageandnotpayahigherpremium(apenalty)ifyoulaterdecidetojoinaMedicaredrugplan.
When Can You Join A Medicare Drug Plan? YoucanjoinaMedicaredrugplanwhenyoufirstbecomeeligibleforMedicareandeachyearfromOctober15thtoDecember7th.
However,ifyouloseyourcurrentcreditableprescriptiondrugcoverage,throughnofaultofyourown,youwill
Important Contact Information • Aetna(Medical)–1-800-445-5299–www.aetna.com• Kaiser(Medical)–303-338-3800–www.kp.org• DeltaDentalofColorado(Dental)–1-800-610-0201–www.deltadentalco.com• VSP(Vision)–1-800-877-7195–www.vsp.com• RockyMountainReserve(FSAAccounts)–1-888-722-1223–www.rockymountainreserve.com• Unum(LifeInsuranceandLong-TermDisability–1-866-679-3054–www.unum.com• EmployeeAssistanceProgram–1-800-854-1446–www.unum.com/lifebalance• Aflac–1-800-433-3036–www.aflacgroup.com• FidelityInvestments401(K)–1-800-294-4015–www.netbenefits.com• VasaFitness–www.vasafitness.com• TicketsatWork–www.ticketsatwork.com(companycode–afwonline)• Employeeportalforpaystatement,updatingcontactinformation,andenrollingintobenefits www.MY.AFW.net• BenefitsDepartment–720-873-8611or720-873-8655• AllHRContactsatmy.AFW.net.
2020 Benefits Guide: October 201919
alsobeeligibleforatwo(2)monthSpecialEnrollmentPeriod(SEP)tojoinaMedicaredrugplan.
What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?IfyoudecidetojoinaMedicaredrugplan,yourcurrentAmericanFurnitureWarehousecoveragewillnotbeaffected.YoucankeepyourAmericanFurnitureWarehousecoverageifyouelectMedicarePartDandyourAmericanFurnitureWarehouseplanwillcoordinatewithPartDcoverage.
IfyoudodecidetojoinaMedicaredrugplananddropyourcurrentAmericanFurnitureWarehousecoverage,beawarethatyou,andyourdependents,willbeabletogetthiscoverageback.
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? YoushouldalsoknowthatifyoudroporloseyourcurrentcoveragewithAmericanFurnitureWarehouse,anddon’tjoinaMedicaredrugplanwithin63continuousdaysafteryourcurrentcoverageends,youmaypayahigherpremium(apenalty)tojoinaMedicaredrugplanlater.Ifyougo63continuousdaysorlongerwithoutcreditableprescriptiondrugcoverage,yourmonthlypremiummaygoupbyatleast1%oftheMedicarebasebeneficiarypremiumpermonth,foreverymonththatyoudidnothavethatcoverage.Forexample,ifyougonineteenmonthswithoutcreditablecoverage,yourpremiummayconsistentlybeatleast19%higherthantheMedicarebasebeneficiarypremium.Youmayhavetopaythishigherpremium(apenalty)aslongasyouhaveMedicareprescriptiondrugcoverage.Inaddition,youmayhavetowaituntilthefollowingOctobertojoin.
For more information about this notice or your current prescription drug coverage, contact the person listed below for further information.
Beverly Zimmerman 8820 American Way, Englewood, CO 80112 P: 720-873-8611 E: [email protected]
NOTE:DependingonyourMedicareeligibility,you’llgetthisnoticeeachyear,beforethenextperiodyoucanjoinaMedicaredrugplan,andifthiscoveragethroughAmericanFurnitureWarehousechanges.Youalsomayrequestacopyofthisnoticeatanytime.
For More Information About Your Options Under Medicare Prescription Drug Coverage:MoredetailedinformationaboutMedicareplans,thatofferprescriptiondrugcoverage,isinthe“Medicare&You”handbook.You’llgetacopyofthehandbookinthemaileveryyearfromMedicare.YoumayalsobecontacteddirectlybyMedicaredrugplans.
FormoreinformationaboutMedicareprescriptiondrugcoverage:• Visitwww.medicare.gov• CallyourStateHealthInsuranceAssistanceProgram(seetheinsidebackcoverofyourcopyofthe “Medicare&You”handbookfortheirtelephonenumber)forpersonalizedhelp.• Call1-800-MEDICARE(1-800-633-4227).TTYusersshouldcall1-877-486-2048.
Ifyouhavelimitedincomeandresources,extrahelppayingforMedicareprescriptiondrugcoverageisavailable.Forinformationaboutthisextrahelp,visitSocialSecurityonthewebatwww.socialsecurity.gov,orcallthemat1-800-772-1213(TTY1-800-325-0778).
Remember:KeepthisCreditableCoveragenotice.IfyoudecidetojoinoneoftheMedicaredrugplans,youmayberequiredtoprovideacopyofthisnoticewhenyoujointoshowwhetherornotyouhavemaintainedcreditablecoverageand,therefore,whetherornotyouarerequiredtopayahigherpremium(apenalty).
2020 Benefits Guide: October 2019 20
UpdatedApril1,2011AccordingtothePaperworkReductionActof1995,nopersonsarerequiredtorespondtoacollectionofinformationunlessitdisplaysavalidOMBcontrolnumber.ThevalidOMBcontrolnumberforthisinformationcollectionis0938-0990.Thetimerequiredtocompletethisinformationcollectionisestimatedtoaverage8hoursperresponseinitially,includingthetimetoreviewinstructions,searchexistingdataresources,gatherthedataneeded,andcompleteandreviewtheinformationcollection.Ifyouhavecommentsconcerningtheaccuracyofthetimeestimate(s)orsuggestionsforimprovingthisform,pleasewriteto:CMS,7500SecurityBoulevard,Attn:PRAReportsClearanceOfficer,MailStopC4-26-05,Baltimore,Maryland21244-1850.Marketplace Notice RE: New Health Insurance Marketplace Coverage Options and Your Health Coverage TheFederal GovernmentrequiresthatallemployersprovidetheenclosedNotice(nextpage)toallemployees.PleasereadonforanexplanationoftheNotice.
OnJanuary1,2019,theindividualmandateunderfederallawwaseffectivelyrepealed.Asaresult,beginningwithtaxyear2019,afederaltaxpenaltynolongerappliestoindividualswithouthealthinsurancecoverage.Forhelpwithindividualmandatecomplianceinpriortaxyears,clickhere.
Forindividualsneedingtopurchasehealthinsuranceontheirown,eachStateintheU.S.musthaveapublicMarketplacewebsiteandcallcenterwhereindividualsmayshopforprivatehealthinsurance.StatesarealsointegratingenrollmentforMedicaidandtheChildren’s Health Insurance Program (CHIP)intothepublicMarketplacetodirectpeopleintothoseprograms,iftheyqualify,insteadofpurchasingprivatecoverage.
PublicMarketplaceswerescheduledtoopenonOctober1,2013forhealthinsuranceshopping,withcoveragethatstartedasearlyasJanuary1,2014.PleasenotethatinsurancecompaniesarenotrequiredtoparticipateintheState’spublicMarketplace,soindividualsmaynotseeallplansthatareavailableintheircommunitywhenshoppingthepublicMarketplace.
AspartofthenewpublicMarketplaces,theHealth Care Reformlawalsocreatesnewfederaltaxcreditstohelppayforcoverage.Thereareseveralrequirementsanindividualmustsatisfytoqualifyforthesetaxcredits.Onerequirementisthattheindividualcannothaveaccesstoemployer-sponsoredhealthinsurancethatmeetsthequalifyingstandardsoftheHealth Care Reformlaw.
American Furniture Warehouse (AFW) will continue to provide health insurance plan options for you, if eligible, and your eligible dependents. The AFW health plan will provide at least one plan option in each geographic region that meets the qualifying standards of the Health Care Reform law.Asaresult,ifyouorafamilymemberwanttocompareyourhealthinsuranceoptionsinthepublicMarketplacetothehealthinsuranceofferedthroughAFW,you’llneedtoconsiderthefollowing:
• YouwillpayfullretailpriceforpublicMarketplaceinsurance(withoutthenewtaxcredits).• Youwillnotbeabletopayforhealthinsuranceonapre-taxbasis.• Youwillnothaveanemployercontributiontowardyourhealthinsurance.
• Youwillcontacttheinsurancecompanyyouselectdirectlywithanyquestions.TheAFWBenefits DepartmentwillnotbeabletoassistyouwithyourpublicMarketplaceplan.• ShouldyouwanttoreturntotheAFWhealthplaninthefuture,youwilleitherneedtoexperiencea federallyrecognized“qualifyingevent”thatallowsamid-yearplanelectionchangeorwaituntilAFW’s nextannualOpenEnrollmentperiod.
IfyouorsomeoneinyourhouseholdarenoteligiblefortheAFWhealthplanandwishtoapplyforapublicMarketplacetaxcredit,yourhouseholdincomemustbewithincertainlimits.Whenyouapplyforthetaxcredit,youwillestimateyourhouseholdincome.Ifyourhouseholdincomeendsuphigherthanyouestimated,youmayowesomeorallofthetaxcreditsbackonyourpersonaltaxreturn.
2020 Benefits Guide: October 201921
Please note this mandatory Notice briefly explains public Marketplaces and how they may be accessed, your AFW benefit enrollment notice will be given to you at your New Hire Orientation and sent via personal email. The enrollment will need to be done by visiting my.AFW.net employee benefit portal within the first 60 days of employment.
AFW Benefits Dept. Beverly Zimmerman / 720.873.8611 / [email protected]
New Health Insurance Marketplace Coverage Options and Your Health Coverage
PART A: General Information :
What is the Health Insurance Marketplace?
Can I Save Money on my Health Insurance Premiums in the Marketplace?
Does Employer Health Coverage Affect Eligibility for Premium Savings through the Marketplace?
How Can I Get More Information?
Form Approved OMB No. 1210-0149
5 31 2020
Beverly Zimmerman 720 873 8611
2020 Benefits Guide: October 2019 22
New Health Insurance Marketplace Coverage Options and Your Health Coverage
PART A: General Information :
What is the Health Insurance Marketplace?
Can I Save Money on my Health Insurance Premiums in the Marketplace?
Does Employer Health Coverage Affect Eligibility for Premium Savings through the Marketplace?
How Can I Get More Information?
Form Approved OMB No. 1210-0149
5 31 2020
Beverly Zimmerman 720 873 8611
PART B: Information About Health Coverage Offered by Your Employer
3. Employer name 4. Employer Identification Number (EIN)
5. Employer address 6. Employer phone number
7. City 8. State 9. ZIP code
10. Who can we contact about employee health coverage at this job?
11. Phone number (if different from above) 12. Email address
American Furniture Warehouse 84-0581547
8820 American Way 720 873 8611
Englewood Colorado 80112
Beverly Zimmerman
720 873 8611 [email protected]
�
If you are a full-time employee or work and average of 30 hours a week or more in our measurement period.
Your legally married spouse. Your children under the age of 26, regardless of student, marital, or tax-dependentstatus (including a stepchild, legally adopted child, a child placed with you for adoption, or a child for whom you arethe legal guardian). Your dependent children of any age who are physically/mentally can't care for themselves.
2020 Benefits Guide: October 201923
13. Is the employee currently eligible for coverage offered by this employer, or will the employee be eligible inthe next 3 months?
Yes (Continue)13a. If the employee is not eligible today, including as a result of a waiting or probationary period, when is the
employee eligible for coverage? (mm/dd/yyyy) (Continue)No (STOP and return this form to employee)
14. Does the employer offer a health plan that meets the minimum value standard*?Yes (Go to question 15) No (STOP and return form to employee)
15. For the lowest-cost plan that meets the minimum value standard* offered only to the employee (don't includefamily plans): If the employer has wellness programs, provide the premium that the employee would pay if he/ shereceived the maximum discount for any tobacco cessation programs, and didn't receive any other discounts based onwellness programs.a. How much would the employee have to pay in premiums for this plan? $b. How often? Weekly Every 2 weeks Twice a month Monthly Quarterly Yearly
16. What change will the employer make for the new plan year?Employer won't offer health coverageEmployer will start offering health coverage to employees or change the premium for the lowest-cost plan available only to the employee that meets the minimum value standard.* (Premium should reflect thediscount for wellness programs. See question 15.)
a. How much would the employee have to pay in premiums for this plan? $b. How often? Weekly Every 2 weeks Twice a month Monthly Quarterly Yearly
2020 Benefits Guide: October 2019 24
American Furniture Warehouse - Corporate Offices8820 American Way, Englewood, CO 80112