Benefits for Leaders

for Pacesetters and APs

start

Benefits

>

If you have a what???

• During open enrollment

• Within 30 days of a qualifying event

• Within 30 days of hire/rehire

When can you enroll in benefits?

Thing you need to know

#1

Full Time Teammate

Approved!

>

$30,000 -or- $50,000

• Becoming a Full time teammate

• Gaining/losing medicare

• Turning 26 (you or your child)

• Death of spouse or child

• Divorced/legally separated

• Having or adopting a baby

• Married

What's a qualifying event?

>

Medical Insurance

>

* Children must be under 26

• Yourself

• Yourself+children*

• Yourself+Spouse (Legally married only)

• Yourself+family (Spouse and children)

• Legal Dependents**

Who can be covered?

>

Court Order ~~~~~~ ~~~~ ~~~~~~~ ~~~~~~ ~~~~~ ~~~~~~

Sibling

Niece/Nephew

Parent

...Maybe

Can I cover my parent, niece, sibling, etc.?

>

Premiums are like an Amazon Prime membership. You pay for the subscription, and then if you want to buy anything, you save money. A premium is how much you pay each paycheck to have benefits. Then if you use your benefits you save money.

Premiums

We want to take care of our teammates so Risas pays a large portion of the cost of their insurance, or premiums, for them. If you decide to leave Risas you can continue your medical coverage, but will need to pay both the teammate cost and the Risas cost to keep the medical benefits.

Risas pays most of the cost for you?

Did you know ....

>

The green plan or Choice Plus is slightly more expensive. It is designed for people who use benefits more often.

Green Plan

The blue plan or HSA Plan is cheaper. It is designed for people who do not use benefits often and prefer coverage for emergencies.

Blue Plan

>

$7,000 Ins paid

$12,000 Expense

$5,000 Deductible

($3,500+$1,500 you paid)

>

On the blue plan, you pay all medical and prescription expenses until you have paid $2,500 for the year (or $5,000 per person if you have others on your insurance). Then the insurance discount kicks in and they cover 100% of remaining expenses.

The deductible is how much you have to pay before your insurance kicks in with the discount.

I'm still lost, what's a deductible?

$5,000 Deductible

$3,500 Expense

$7,000 Expense

$5,000 $5,500 ins. paid

Family Deductible of $2,500 met!

$1,200 + $1,500 = $2,700

>

On the green plan, you pay all medical expenses that are not covered by a copay, until you have paid $750 for the year (or $2,500 by everyone covered on your insurance). Then the insurance discount kicks in and they cover 80% of remaining expenses until you hit the maximum, which is $3,250 for an individual covered on the insurance or $6,500 total for everyone on the family. The family maximum is nice so that you don't spend $3,250 for yourself, $3,250 for your spouse, and $3,250 for each of your children.

I'm still lost, what's a deductible?

Green Plan

If we could waive our hand over a crystal ball and see the future we would always know which plan to pick. But unfortunately we can't. So you must make the best decision you can with the information at hand, knowing that choosing benefits is always a bit of a gamble.

>

The future is uncertain

Prescription benefits are covered under your medical insurance. Risas uses a provider that can help you get a discount on your prescriptions by international sourcing and other means.

>

*Some prescriptions may even be free!

Prescription

FSA, HSA, DFSA

>

''

>

Health Savings Account (HSA)

This account allows you to set aside money from your paycheck for medical expenses, before Uncle Sam can take out taxes. This saves you money!

>

Flexible Spending Account (FSA)

This account works like an HSA but with a few key differences. It's good for the whole village! Whether you choose blue or green you can get an FSA.

Krogg's Daycare

>

Dependent Flexible Spending Account (DFSA)

This account allows you to save pretax dollars, so you are saving money, to cover child care expenses.

HSA

FSA

family

Healthy

Deductible

Copay

Which plan or plans can enroll in an FSA, or Flexible Spending Account?

Which plan is best for the EE who never gets sick and is not covering any family?

Which plan has the best deductible for covering 2 or more people?

Which plan or plans have a deductible?

Both

Which plan or plans has copays?

Which plan or plans can enroll in an HSA, or Health Savings Account?

BluePlan

GreenPlan

Match the insurance plan

Drag each finger to the correct plan.

>

Vision & Dental

>

early vision tests

The app has a section for special offers which change from time to time. May include:

• FREE frames at LensCrafters and Target optical
• $1,200 towards Lasik and other Lasik deals
• Savings on contacts
• and more...

Under MyBenefits you will find an insurance card for hearing care as well which provides discounts on hearing aids.

Special Details

• Eye Exam: $10 copay
• Lenses: $25 copay
• Frames: $130 allowance and 20% off the balance
• Standard contacts:
• Fitting: $40 copay
• Conventional: $130 allowance
• Disposable: $130 allowance

What is covered

• All teammates
• Legally married spouse
• Children under 26 (Biological, adoptive, step, and foster)

>

Eyemed Vision

You will not receive an insurance card in the mail. Once you enroll, download the EyeMed app to access your digital insurance card.

Who is eligible

Termination

When a teammate leaves Risas their free treatment ends. If they have ortho, they will be responsible for paying $100 per month for the remaining treatment period.

Registering

• General Dentistry at a Risas office
• Metal or ceramic braces
• Aliners for $600
• 20% discount off of oral surgery services and an extra 20% if PIF
• Risas Kids office as indicated in the chart

What is covered

• Full time teammates, after 90 days
• Legally married spouse
• Children under 26 (Biological, adoptive, step, and foster)

>

Dental

Support Center, Pediatric offices, and Oral Surgeons office teammates are required to provide documentation of relationship to HR prior to scheduling an appointment for:

• Spouse-Marriage certificate
• Children-birth certificate, adoption papers, foster papers

Who is eligible

>

FRee: Life, AD&D, and Long Term Disability

RIP

Free benefits

Pays 1x your salary up to $50k to your beneficiary. Make sure your beneficiary is at least 21 to avoid extra legal issues.

Life Insurance

Pays 1x your salary up to $50k to a beneficiary if your death is the result of an accident (like a car accident).

>

Accidental Death & Dismemberment

After being disabled for 90 days, you get 60% of your pay up to $10,000 per month.

Long Term Disability

RIP

Voluntary Benefits

>

Eligible after being disabled for 7 days. Up to 60% of your pay, capped at $1,000 a week.

Short Term Disability

You can purchase up to $200,000 in extra life insurance.

Life Insurance

Other Benefits& Info

>

Misc.

The 401k allows loans and hardship withdrawals. You can only close your account when you retire or leave Risas. If you take the money before retirement there are big tax consequences. You can keep the 401k with Risas or roll it to a new employer.

Registering

>

Risas matches the money you put in for both Roth (taxes taken out now) or regular (Taxes taken out when you retire):

• 100% matching on the first 3%
• 50% matching on the next 2%

You can invest the money in stocks, bonds and mutual funds to help it grow. ADP can help with this.You can pause your contributions any time by going back into ADP and changing the amount to zero.

The Benefit

• You must be at least 18
• Worked at Risas for 1 year
• Completed 1,000 hours of service (FT and PT at 20 hrs per wk will hit this requirement in a year)

401K

You will not sign up for 401k during open enrollment. It is done on your own. Once you hit your 1 year and 1,000 hours login to ADP, Myself-Benefits-Retirement and sign up for the 401K.

Who is eligible

Dental Certs

Pet Insurance

2nd Family FOundation

Discounts

Free Counseling

Home Buyer Program

Daca Scholarship

Tuition Assistance

Free Diapers

>

Other Benefits

Open Enrollment!

>

What am I forgetting?

Ensure your address in ADP is correct. Watch your mail carefully to ensure you do not throw away your insurance card. Roughly half of all cards are thrown away. It is a pain for you to order a new one. Benefits selected during Open Enrollment are effective 1/1 and begin coming out of your check on 1/22 (The check that covers your hours for 1/1). Benefits selected by new hires are effective the first of the month after 30 days of employment. They will begin coming out of the check on the 22nd of that month. The benefit poster will indicate if Open Enrollment is passive or active. Active means all your benefits are deleted and you must enroll or you will have nothing in the new year. Passive means you keep all your benefits except the FSA, HSA, and DFSA which must be selected each year. All teammate should complete Open Enrollment, even if it is just to waive benefits. This way HR knows who has not done Open Enrollment and needs to be contacted.

MISC. INFO

CONGRATS! You have successfully completed this course.

How does the FSA work?

The great thing about an FSA is all of the money you will put into it for the year, is available on January 1st. So if you plan to pay $41.66 per check, you will have $1,000 available for medical expenses on day one. Just like an HSA you are using pretax dollars. You are given a credit card to make payments for all your medical needs. The one negative aspect of the FSA card is that the money expires at the end of the year. Unlike the HSA, where the money is yours forever, with an FSA you must use all your funds by December 31, or you will lose them. If you are running out of time to spend your funds there is a store with eligible items you can purchase like tampons, baby monitors, massagers, glasses/contacts, etc.

Example:Juan's wife is pregnant and they have the green plan so he knows his deductible for delivery will be $3,250. She is due February 14th. Juan invests in an FSA and maximizes how much he can contribute. Then when his wife delivers he is able to pay his full deductible, even though he has only contributed $275 into it so far. NOTE: You are not able to drop an FSA during a qualifying event because funds are provided in advance.

Dental certs are not based on reimbursement. They are paid up front by the office on their credit card.

Did you notice???

*Life insurance policies at Risas are not eligible for loans

Formula: ($Amount of insurance you want) / $1,000 = (number of units) (number of units) * (the dollar amount under your age in the chart) = ($ Y) ($Y) / 2 = ($cost per check)

Life insurance, made easy???

ADP will calculate the cost for you. However, it is based on your age and how much insurance you want. You must purchase in increments of $5,000. For example, $5,000; $10,000; $15,000; etc.

Example: A 40 year old woman wants $100k in insurance. That is one hundred $1,000 units of insurance. You multiply 100*$0.118 (the cost per unit from the chart) to get the monthly cost. Then divide by two, to get the cost per check $5.90.

Is the Blue Plan right for you?

Only you can decide, but...

What is great about the blue plan is that is has a low deductible. If only you are covered on the plan, once you spend $2,500 in a year on medical and prescription, the insurance covers 100% of the remaining expenses. So:

• If you are never sick, and don't use the insurance, you save $720 by going blue instead of green.
• If you go to the doctor just once for a cold, you spend $150, and still save $570.
• But if you get in a car accident and have $68,000 in medical bills, you only have to pay $2,500. IF YOU ARE THE ONLY ONE ON THE PLAN.

To decide if the Blue Plan is right for you:

• If you are covering just you, and you go to the doctor 3 or fewer times, it may be cheaper.
• If your prescription costs for the year (Without insurance) are less than $720.
• The blue plan has risks if others are covered. If you add spouse and/or children your deductible becomes $5,000 per person. You pay everything until the deductible for that person is hit.
• If you are in the car accident you pay $5,000 and if your child is hospitalized you pay another $5,000, and if your wife has a baby that's $5,000, for a total of $15,000 in a year.
• If you each go to the doctor once it $450 out of pocket and you save $270.

How does the HSA work?

You must be on the blue plan to qualify for an HSA. You then indicate how much money you want taken from your check for the account. It is added to your account each payday. You are provided a credit card to use for medical expenses and can spend the funds available in your account. The great thing about an HSA is the money is yours. Whether you use some or all this year, 3 years from now, or not until you retire, that money stays yours. Once you get to $2,000 in the account, you can invest it in stocks and bonds to further grow the money. The HSA is a great safety net for those who want the blue plan because they rarely use medical insurance. In a pinch, you will have money to cover your deductible.

Example:Sara decides to get the blue plan for herself and her spouse, which costs $170. If she had the green plan it would be $215. Sara decides to pretend she is on the green plan and put the extra $45 a paycheck into an HSA, paying herself instead of the insurance company. By the end of the year she has $1,080. Which comes in handy the next year when she gets pneumonia. She would have paid $400, but used her HSA to cover it fully, and she still has money set aside.

ADP will handle the calculation because it is extremely complicated, but to give you an idea, for those under 30 making $17 it will be about $18 a check.*Prices vary depending on your hourly rate or salary.

How does Short Term Disability (STD) work?

Just like car insurance or home owners insurance, if you wait until you are in an accident/hit by a tornado, you are too late. Think of STD as an investment in "What if..." If you have the condition 3 months prior to the effective date of the insurance, your disability will not be covered for the first 12 months. In other words, if you are already pregnant it is too late to get short term disability.

Example: Maria wants to have a baby, but can't afford to be on leave without pay. She signs up for STD during Open Enrollment, waits until the new year and then begins trying immediately. She is due October 31st. STD will cover her leave but she will probably have to renew the benefit to have coverage for the full 12 weeks of leave.

How does the DFSA work?

The DFSA is used for childcare expenses. You are given a debit card which may be used at facilities that accept it. Or you can pay your childcare provider and submit a receipt to be reimbursed from your DFSA. You may only spend funds as they are added to the account. Eligible care includes:

• Preschool
• Summer day camp
• Before- or after-school programs
• Child or adult day care
• Babysitting
• Licensed nursery schools
• Application fees for daycare
• Late pickup fees for daycare

Example:Claudia's children are both in daycare. She spends $500 per week. Claudia sets aside the maximum allowed into her DFSA (changes each year) knowing it won't cover the full cost but will help her save some money. She then uses her DFSA debit card once a month towards her day care expenses. Raul's father has dementia. He uses the DFSA to pay for his father's day care while he is at work. It does not cover the entire cost, but helps him save by reducing the taxes he has to pay. He is able to keep more of his money this way.

Do you need the Green Plan?

That's up to you, but...

One of the benefits of the green plan is that it offers copays. These copays save you money each time you use your insurance. So:

• Instead of paying $150 to see the doctor for an ear infection, you pay $25
• Instead of paying $400 for taking your baby to Urgent care with a fever, you pay $75
• Instead of paying $2,600 for visiting the ER with a sprained ankle you thought was broken, you pay $300

It also offers copays on prescriptions, pregnancy visits, specialty, and a $5 copay for teledoc.

To decide if the Green Plan is right for you: Look back at the last two years. How often did you go to the doctor, Urgent Care, or ER? If you are covering just you or the entire family, and you went to your doctor 4 times, the green plan was probably cheaper. If you cover your spouse or children then if you collectively went to the doctor 7 or more times, the green plan is probably cheaper. If you went to urgent care 2 times the green plan is probably cheaper, regardless of who you have covered. If anyone went to the ER, the green plan is cheaper.

Risas has a guide just for teammates who are expecting a baby. It discusses how leave works, the free gift new parents get, the free diapers program and more.

Did you know???

Be sure to tell any expecting teammates to review this guide called "We are expecting... Now what?", located on the ADP homepage.

Stephanie's 401k balance is $2,400 after one year, but she only contributed $1,300 of her own money.

401k Example

• Stephanie makes $25,000 a year and has decided to contribute $50 a paycheck into her 401k.
• Stephanie is contributing 5.2% of her salary or $1,300 a year.
• Risas will match 100% of Stephanie's contributions up to 3% of her salary or $750.
• Risas then matches 50% of Stephanie's contributions for an additional 2% of her salary or $250.
• At the end of the year Stephanie has $2,300 in her retirement account (contribution + Risas match).
• Stephanie picks a fund based on when she plans to retire and she earns an additional $100.