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

Blue Cross Blue Shield of North Carolina

1-877-258-3334

www.bcbsnc.com

HEALTH SAVINGS ACCOUNT

Health Equity

1-877-713-7682

www.myhealthequity.com

VOLUNTARY DENTAL

BCBS

1-877-258-3334

www.bcbsnc.com

VOLUNTARY TERM LIFE

Blue Cross Blue Shield of North Carolina

1-888-723-4476

www.bcbsnc.com

VOLUNTARY DISABILITY

Hartford

1-866-523-2233

www.thehartford.com

SUPPLEMENTAL BENEFITS
RETIREMENT

Raymond James Financial 

Hoyt Family Wealth Management

Keais Hoyt Jr.

844-737-2520

[email protected]

www.hoytfamilywm.com

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.

BCBS Base Plan
BCBS Buy Up Plan
Benefit Highlights
In-Network
Out-of-Network
In-Network
Out-Of-Network
Deductible
                NEW PLAN for 2022
      Individual
$2500
$5000
$1500
$3000
      Family Member
$5000
$10000
$3000
$6000
      Family Maximum
$5000
$10000
$3000
$6000
Coinsurence
30%
60%
20%
50%
Co-insurence Maximums
Includes Deductible
Includes Deductible
Includes Deductible
Includes Deductible
      Individual
$5000
$10000
$3000
$6000
      Family Member
$6650
$13300
$6000
$12000
      Family Maximum
$10000
$20000
$6000
$12000
Inpatient & Outpatient Service
Deductible + 30%
Deductible + 60%
Deductible + 20%
Deductible + 50%
      Wellness Benefit (Adult)
Covered in Full
Not Available
Covered in Full
Not Available
Emergency Room/Urgent Care
Deductible + 30%
Deductible + 30%
Deductible + 20%
Deductible + 20%
Virtual Visit via MDLIVE
                No more than $45
                No more than $45
Prescription Drugs *
Deductible + 30%
Deductible + 30%
Deductible + 20%
Deductible + 20%
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
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:

BASE PLAN (include $8 HAS contribution)
BUY UP PLAN
Employee Only
$40
$48.25
Employee / Spouse
$84
$111.18
Employee / Child
$66
$88.53
Family
$110
$154.43

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.

Total Health Savings Account Contributions per plan year
Base Plan
Buy Up Plan
From your Employer
$500 per enrolled member ($9.62 per week)
None
From you
$416 per plan year.
You can elect any amount up to the IRS limits

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

Weekly Rates will be deducted from your paycheck:
Employee Only
Employee / Spouse
Employee / Child
Family
Employee Pays:
$5
$8
$10
$13

This chart shows how the plan works and how each type of service is covered

Type of Service
Amount You Pay
In Network
Out of Network
Deductible
    Individual
$50
$50
    Family
3 per family
3 per family
Annual Maximum
$1500
$1500
Preventive Services
Three Cleanings per year, Fluoride Treatments, Oral Exams, Sealants,
X-rays
100%,
deductible waived
80%,
deductible waived
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.

Weekly Rates will be deducted from your paycheck:
Employee Only
Employee / Spouse
Employee / Child
Family
Employee Pays:
$1.81
$3.44
$3.62
$5.33
Vision Service
In Network
Out of Network
Eye Exam with Dilation
(if necessary)
$10 copay*
$30 allowance*
Frames:
Member pays 80% after allowance
$130 allowance
$65 allowance
Standard Plastic Lenses:
Single Vision
$25 copay
$25 allowance
Bifocal
$25 copay
$30 allowance
Trifocal
$25 copay
$63 allowance
Lenticular
$25 copay
$63 allowance
Standard Progressive
$25 copay + $65
$39 allowance
Premium Progressive
$10 or $25 copay + up to
$110 depending on level of
progressive lens
$39 allowance
Lasik Vision Correction
15% off retail price or 5% off
of promotional price
Not Available
Contact Lenses:
Conventional
$130 allowance
$104 allowance
Disposable
$130 allowance
$104 allowance
Frequency:
Exam
Every 12 months
Frames
Every 24 months
Lenses
Every 12 months

*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

EMPLOYEE BENEFIT
Up to 5 times salary, to a maximum of $50,000
SPOUSE BENEFIT
50% of employee coverage to a max of $25,000
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
20-24
$0.074
25-29
$0.087
30-34
$0.101
35-39
$0.121
40-44
$0.183
45-49
$0.282
50-54
$0.426
55-59
$0.715
60-64
$0.826
65-69
$1.339
70-74
$2.443
75+
$4.913
Voluntary AD & D Rate
per $1000
$0.025
All Children Rate per
per $1000
$0.16
Voluntary Family
AD&D Rate per $1000
$0.038

Example of how to calculate the Voluntary Life/AD&D cost:

  1. Find your age in the table.
  2. Multiply the rate for life and AD&D by the amount of coverage you want per $1,000’s.
  3. 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.
  4. 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.
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.

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.