2022 Benefit Summary
Plan Year
|
2022
Plan Year
|
2022
Our employees are our most valuable asset.
That’s why at Personnel Outsource Solutions, we are committed to a comprehensive employee
benefit program that helps our employees stay healthy, feel secure, and maintain a work/life balance.
Stay Healthy
- Medical
- Dental
- Vision
Feeling Secure
- Life and Accidental Death & Dismemberment
- Disability
- Supplemental Benefits
- 401K
- BB&T @ Work
Work/Life Balance
- Paid Time Off
Contact Information
Refer to this list when you need to contact one of your benefit vendors. For general information
contact the Corporate Office
MEDICAL
HEALTH SAVINGS ACCOUNT
VOLUNTARY DENTAL
VOLUNTARY TERM LIFE
VOLUNTARY DISABILITY
SUPPLEMENTAL BENEFITS
RETIREMENT
Raymond James Financial
Hoyt Family Wealth Management
Keais Hoyt Jr.
844-737-2520
PAID TIME OFF
Local Site Manager
Corporate Office 1-866-527-0839
Who is Eligible and When:
All full-time employees are eligible for medical after they have completed their 60-day probationary period. Should you elect coverage,
your effective date will be the first of the month after your 60 days.
You have TWO medical plans to choose from, both are High Deductible Health Plans that you can pair with a Health Savings Account
(HSA) through BCBS and their partner Health Equity. Your HSA will automatically be set up when you enroll in the BASE medical plan.
The HSA account is designed for you to use the money deposited by you and/or Personnel Outsource to pay for qualified medical
expenses.
For a more detailed look at the available plans, review the benefit summary in Employee Navigator.
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BCBS Base Plan
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BCBS Buy Up Plan
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|---|---|---|---|---|
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Benefit Highlights
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In-Network
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Out-of-Network
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In-Network
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Out-Of-Network
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Deductible
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NEW PLAN for 2022
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|
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Individual
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$2500
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$5000
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$1500
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$3000
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Family Member
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$5000
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$10000
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$3000
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$6000
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Family Maximum
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$5000
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$10000
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$3000
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$6000
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Coinsurence
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30%
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60%
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20%
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50%
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Co-insurence Maximums
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Includes Deductible
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Includes Deductible
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Includes Deductible
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Includes Deductible
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Individual
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$5000
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$10000
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$3000
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$6000
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Family Member
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$6650
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$13300
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$6000
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$12000
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Family Maximum
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$10000
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$20000
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$6000
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$12000
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Inpatient & Outpatient Service
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Deductible + 30%
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Deductible + 60%
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Deductible + 20%
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Deductible + 50%
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Wellness Benefit (Adult)
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Covered in Full
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Not Available
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Covered in Full
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Not Available
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Emergency Room/Urgent Care
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Deductible + 30%
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Deductible + 30%
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Deductible + 20%
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Deductible + 20%
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Virtual Visit via MDLIVE
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No more than $45
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No more than $45
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Prescription Drugs *
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Deductible + 30%
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Deductible + 30%
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Deductible + 20%
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Deductible + 20%
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Note: Drugs listed on the Enhanced Preventive List are available for coinsurance with the deductible being waived. This list contains maintenance medications you would take each month for conditions such as: Asthma, Diabetes, and Hypertension. The list is available on Employee Navigator
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Total Health Savings Account
Contributions per plan year (Employer + Employee)) |
Employee: $916
|
Your account will
automatically be opened by BCBS and Healthy Equity. |
No Employer
contribution for this plan |
You may elect to
contribute to your HSA |
2022 Weekly Medical Rates:
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|
BASE PLAN (include $8 HAS contribution)
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BUY UP PLAN
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|---|---|---|
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Employee Only
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$40
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$48.25
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Employee / Spouse
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$84
|
$111.18
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Employee / Child
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$66
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$88.53
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Family
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$110
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$154.43
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Employees enrolled in the BASE plan will automatically have a Health Savings Account open on their behalf. Health Equity is the HSA vendor through Blue Cross Blue Shield. If you enroll in the BUY UP plan you may elect to set up an HSA plan on your own and contribute if you choose.
You can make pre-tax contributions to pay for qualified medical expenses for you or your family even if they are not enrolled in the medical plan. Please refer to the Enrollment Change form or Annual Election Form to make an election. A HealthEquity Visa® Health Account Card is supplied to you, to conveniently pay for eligible medical expenses.
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Total Health Savings Account Contributions per plan year
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|---|---|---|
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Base Plan
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Buy Up Plan
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From your Employer
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$500 per enrolled member ($9.62 per week)
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None
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From you
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$416 per plan year.
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You can elect any amount up to the IRS limits
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Note: The Employer Contribution is prorated if you enroll after the beginning of the plan year.
You may also add additional monies to your account by completing a form. The IRS will allow you to add additional money to your HSA account; you can contribute up to $3,650 single or $7,300 family max per year.
NOTE: You may opt out of the $8.00 HSA contribution at your initial enrollment or by completing the Annual Open Enrollment Form.
Your account will automatically be opened by BCBS and Health Equity. If you do not receive a debit card please contact Health Equity 866-346-5800.
Sample eligible health expenses:
Acupuncture Birth Control Pills Chiropractor Contact Lenses Dental Treatment
Hearing Aids Prescription Drugs Vision Care Physical Therapy Psychiatric Care
With an HSA, you can:
- Deposit your health care dollars you can change your contribution amount at any time as long as you don’t exceed the 2020 annual limits set by the Internal Revenue Service (IRS) ($3,600 for individuals and $7,200 for families). If you’re 55 or older, you may also make an additional $1,000 catch-up contribution. Personnel Outsource Solutions contributions count towards this limit.
- Grow your savings HSA deposits may earn interest and you may be able to invest a portion of your balance in mutual funds. In order to invest a minimum balance is required.
- Save on taxes your deposits are exempt from federal income tax and interest earned is accumulated tax free in most states. Money you spend on qualified expenses is income tax free.
- Pay for health care, now or later you can use your HSA to pay for qualified medical, dental, and vision expenses now or in the future. Funds you withdraw from your HSA are tax-free when used to pay for qualified medical expenses as described in Section 213(d) of the IRS Tax Code. The expenses must be medically necessary. A list of these expenses is available at www.irs.gov in IRS Publication 502, “Medical and Dental Expenses.”
Save your receipts for all qualified medical expenses, in the event of an IRS audit you may need to provide substantiation of the withdrawals from your HSA account.
Your HealthEquity Visa® will arrive by mail shortly after you are enrolled in the plan in an unmarked envelope. If you do not receive – please contact Health Equity.
Once your account has been successfully opened Personnel Outsource Solutions will contribute the annual $500 contribution to your HSA account on a weekly basis; $9.62 will be deposited into your Health Savings Account
Who is Eligible and When:
All full-time employees are eligible for voluntary dental coverage after they have completed their 60-day probationary period. Should you elect coverage, your effective date will be the first of the month after your 60 days.
Benefits You Receive:
Your dental plan is a PPO dental plan, so you would choose a dentist that is in the BCBS dental network. For a directory of in-network dentists, visit the website at www.bcbsnc.com.
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Weekly Rates will be deducted from your paycheck:
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|---|---|---|---|---|
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Employee Only
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Employee / Spouse
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Employee / Child
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Family
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Employee Pays:
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$5
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$8
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$10
|
$13
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This chart shows how the plan works and how each type of service is covered
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Type of Service
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Amount You Pay
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|---|---|---|
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In Network
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Out of Network
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Deductible
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|
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Individual
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$50
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$50
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Family
|
3 per family
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3 per family
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Annual Maximum
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$1500
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$1500
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Preventive Services
Three Cleanings per year, Fluoride Treatments, Oral Exams, Sealants, X-rays |
100%,
deductible waived |
80%,
deductible waived |
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Basic Services
Anesthesia, Filings, Perio, Root canal, Simple Extractions |
80%, after deductible
|
60%, after deductible
|
|
Major Services
Bridges & Dentures, Inlays, Onlays, Veneers, Single Crowns, Surgical Extractions, Repair and maintenance of Crowns, Bridges & Dentures. |
50%, after deductible
|
50%, after deductible
|
|
Orthodontia-Children
Lifetime Maximum |
50%
$1500 |
50%
$1500 |
*BCBS does not pay out of network providers directly. All claims reimbursements will be sent to the member to remit payment to the provider
Who is Eligible and When:
All full-time employees are eligible for voluntary vision coverage after they have completed their 60-day probationary period. Should you elect coverage, your effective date will be the first of the month after your 60 days
Benefits You Receive:
Your vision plan is offered through BCBS who has partnered with Eye Med vison, so you would choose an eye doctor that is in the Eye Med network to receive the best benefits of the vision plan. You can visit any Eye doctor you wish however if they are not in network, out of network benefits would apply. For a directory of in-network doctors, visit the website at www.eyemedvision.com.
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Weekly Rates will be deducted from your paycheck:
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|---|---|---|---|---|
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Employee Only
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Employee / Spouse
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Employee / Child
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Family
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Employee Pays:
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$1.81
|
$3.44
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$3.62
|
$5.33
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Vision Service
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In Network
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Out of Network
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|---|---|---|
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Eye Exam with Dilation
(if necessary) |
$10 copay*
|
$30 allowance*
|
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Frames:
Member pays 80% after allowance |
$130 allowance
|
$65 allowance
|
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Standard Plastic Lenses:
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Single Vision
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$25 copay
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$25 allowance
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Bifocal
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$25 copay
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$30 allowance
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Trifocal
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$25 copay
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$63 allowance
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Lenticular
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$25 copay
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$63 allowance
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Standard Progressive
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$25 copay + $65
|
$39 allowance
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Premium Progressive
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$10 or $25 copay + up to
$110 depending on level of progressive lens |
$39 allowance
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Lasik Vision Correction
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15% off retail price or 5% off
of promotional price |
Not Available
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Contact Lenses:
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Conventional
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$130 allowance
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$104 allowance
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Disposable
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$130 allowance
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$104 allowance
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Frequency:
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Exam
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Every 12 months
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Frames
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Every 24 months
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Lenses
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Every 12 months
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*Copay– is what the member pays for that service.
*Allowance-is what the plan gives a member credit for towards that particular service. Members are responsible for costs exceeding the allowance.
Who is Eligible and When:
All full-time employees are eligible for voluntary vision coverage after they have completed their 60-day probationary period. Should you elect coverage, your effective date will be the first of the month after your 60 days
Benefits You Receive:
Term Life Insurance
Hartford offers supplemental life coverage protection at economical group rates. The younger you are, the less it costs. For older employees, life coverage provides a cost-effective addition to estate planning
Accidental Death & Dismemberment
The AD&D Principal Sum amount is equal to the amount of voluntary term life insurance for employees and eligible dependents
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|---|---|
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EMPLOYEE BENEFIT
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Up to 5 times salary, to a maximum of $50,000
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SPOUSE BENEFIT
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50% of employee coverage to a max of $25,000
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CHILD BENEFIT
Children age 14 days to 26 years |
25% of employee coverage to a max of $5,000
Coverage limits are based on child age |
Life & AD&D Rates
|
Age
|
Employee & Spouse
Rate per $1,000 |
|---|---|
|
<19
|
$0.107
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20-24
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$0.074
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25-29
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$0.087
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30-34
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$0.101
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35-39
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$0.121
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40-44
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$0.183
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45-49
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$0.282
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50-54
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$0.426
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55-59
|
$0.715
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60-64
|
$0.826
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65-69
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$1.339
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70-74
|
$2.443
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75+
|
$4.913
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Voluntary AD & D Rate
per $1000 |
$0.025
|
|
All Children Rate per
per $1000 |
$0.16
|
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Voluntary Family
AD&D Rate per $1000 |
$0.038
|
Example of how to calculate the Voluntary Life/AD&D cost:
- Find your age in the table.
- Multiply the rate for life and AD&D by the amount of coverage you want per $1,000’s.
- Calculate the cost of coverage for your spouse, by using your age, and multiply the rate in the spouse column by the amount of coverage per $1,000’s you want.
- Add the premiums for you, your spouse, and your children to get your total monthly cost.
Example:
Employee age 28 wants $30,000 in coverage
30 x $0.087 per $1,000 = $2.61 per month
30 x 0.025 per $1,000 = $0.75 per month
$3.36 total per month x 12 / 52 weeks =$0.78 per pay
Who is Eligible and When:
All full-time employees are eligible for voluntary vision coverage after they have completed their 60-day probationary period. Should you elect coverage, your effective date will be the first of the month after your 60 days
Benefits You Receive:
Hartford offers short-term and long-term disability coverage. Disability from an accident or illness can strike anyone at any age. Disability insurance provides a regular check to help pay monthly bills when you are unable to work.
Short-Term and Long-Term Coverage
- Short-term disability benefits start within days of the illness or injury but are payable for a limited time period.
- Long-term disability benefits start within months of the illness or injury but may continue until retirement.
- If you have short-term and long-term disability coverage with Hartford, you will not be required to submit a second claim form for the long-term benefits.
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COVERAGE
|
SHORT-TERM DISABILITY
|
LONG-TERM DISABILITY
|
|---|---|---|
|
Coverage Amount
|
66.7% of salary to a maximum of
$300/week |
60% of salary to a maximum benefit of
$4,000/month |
|
Maximum payment period
|
26 Weeks
|
Social Security Normal Retirement
Age |
|
Accident Benefits Begin
Illness Benefits Begin |
Day 8
Day 8 |
Day 181
Day 181 |
STD Premium Rates – $0.89 per $10 of Weekly Benefit
LTD Premium Rates – $0.50 per $100 of Monthly Benefit
STD Calculation:
(Annual Salary x Weekly Benefit %) /52 weeks = Maximum Weekly Benefit (Up to $300 max)
((Maximum Weekly Benefit /$10) * $0.890(rate))* 12 months)/52 weeks = Your Premium
Deduction
($20,800 x 66.7%)/52 = $266.80
(($280 / $10) x $0.89) x 12)/ 52 = $5.75 deduction per week
LTD Calculation:
(Annual Salary x Monthly Benefit %) /12 mths = Maximum Monthly Benefit (up to $4,000 max)(Max. Mthly Benefit /$100) x rate) x 12)/52weeks
($20,800 x 60%)/12 = $1,040
(($1,040 /$100) x $0.50) x 12) / 52 = $1.20
Who is Eligible and When:
All full-time employees are eligible for voluntary vision coverage after they have completed their 60-day probationary period. Should you elect coverage, your effective date will be the first of the month after your 60 days
Benefits You Receive:
The Hartford Supplemental Benefit polices pay regardless of any other insurance; and the cash benefits are paid directly to you. The Hartford benefits may help pay deductibles, copayments, child care, house payments, or rent, car payments, groceries and utility bills. You decide what to use the benefit payments you receive from the Hartford.
PLANS AVAILABLE:
- 24-Hour On or Off the Job Accident Plan – provides benefits payable to you as if you have an accident. The plan pays based on a schedule of Emergency, Hospital and Injury Treatments. There is also a $25,000 accidental death benefit with this policy.
- Critical Illness with Cancer Care Plan – Choose between a $10,000 or $20,000 lump sum benefit if you are diagnosed with any of the following covered illnesses: Cancer, Heart Attack, Organ Transplant, End stage Renal failure, Paralysis, Coma, ALS, MS, or Advanced Parkinson’s disease. Pre-Existing limitations may occur.
- Critical Illness Coverage – Choose between a $10,000 or $20,000 lump sum benefit if you are diagnosed with any of the following covered illnesses: Heart Attack, Organ Transplant, End stage Renal failure, Paralysis, Coma, ALS, MS, or Advanced Parkinson’s disease. Pre-Existing limitations may occur.
- Hospital Indemnity Plan – provides benefits to you if you are confined inpatient to a hospital. Benefits are payable based on a schedule. Pre-Existing limitation may occur. There are three different plans to choose from.
The Hartford Supplemental Benefit plans are available to employees and their dependents. Wellness benefits are available with the Critical Illness polices. If you have a preventive care screening The Hartford will pay a $75 benefit.
401K Retirement Savings plan
Who is Eligible and When:
All full-time employees are eligible for the American Funds 401K plan after they have completed their 60-day probationary period.
Benefits You Receive:
Personnel Outsource Solutions offers a (401K) savings plan for your retirement through American Funds. With this plan you may contribute a portion of your paycheck into the plan in order to save for your retirement. In addition to your contributions, Personnel Outsource Solutions will match 100% of your contributions up to the first 2%. Personnel Outsource Solutions will match contributions from 2%- 6% on a 50/50 split between you and the company.
Who is Eligible and When:
All full-time employees are eligible for paid time off after they have completed their 60-day probationary period
Vacation and Personal Time
Vacation and personal day are to be used in the year it is earned and will not be carried over into the following year. After an employee works their first full year following the passing of the employee’s relevant anniversary date, the employee is eligible for one week’s vacation and two personal days. Employees receive two (2) personal day per year regardless of the number of years of service. Employees who have completed the following years of service receive the corresponding number of weeks of paid vacation as indicated in the chart below.
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Years of Eligible Service
|
Vacation Days Earned Each Year
|
|---|---|
|
After 1 year
|
1 week (40 hours)
|
|
After 2 years
|
2 weeks (80 hours)
|
|
After 7 years
|
3 weeks (120 hours)
|
|
After 14 years
|
4 weeks (160 hours)
|
Holidays
As a full-time employee, you will receive the following paid holidays each year:
- New Year’s Day
- Labor Day
- Two Personal Days (after 1 year of service and may be taken any time.)
- Memorial Day
- Thanksgiving Day
- July 4th
- Christmas Day
This document is a brief summary of benefits offered as of 1/1/2022 and is not considered “Evidence of Coverage.” Please refer to the policy/plan documents for a complete description of the controlling terms, coverages, exclusions, limitations and conditions of coverage. In case of any discrepancy between this information and the policy/plan documents, the policy/plan documents will prevail.
Personnel Outsource Solutions reserves the right to terminate, suspend, withdraw, or modify the benefits described in the policy/plan documents, in whole or in part, at any time. No statement in this or any other document and no oral representation should be construed as a waiver of this right. This summary is the confidential property of Personnel Outsource Solutions.
Insurance information prepared by Relation Insurance, Inc. Other content provided by Personnel Outsource Solutions.
This document is a brief summary of benefits offered as of 1/1/2022 and is not considered “Evidence of Coverage.” Please refer to the policy/plan documents for a complete description of the controlling terms, coverages, exclusions, limitations and conditions of coverage. In case of any discrepancy between this information and the policy/plan documents, the policy/plan documents will prevail.
Personnel Outsource Solutions reserves the right to terminate, suspend, withdraw, or modify the benefits described in the policy/plan documents, in whole or in part, at any time. No statement in this or any other document and no oral representation should be construed as a waiver of this right. This summary is the confidential property of Personnel Outsource Solutions.
Insurance information prepared by Relation Insurance, Inc. Other content provided by Personnel Outsource Solutions.
