2017 Benefits Overview
WHO IS ELIGIBLE?
Full-time employees (30 or more hours per week) are eligible to participate with their eligible family
members in the benefits offered by Leiter’s.
- Spouse or Domestic Partner
- Dependent Children
- Adult Children up to age 26
WHEN DO I ENROLL?
Full-time employees are eligible to enroll with coverage effective the1st of the month following the date of full-time employment. Human Resources will provide instructions as to the enrollment procedure. If you do not enroll yourself and/or your eligible dependents during your initial eligibility period, you will have to wait until the next open enrollment to enroll -- unless you and/or your eligible dependents experience a “qualifying event,” for example, loss of other coverage.
HOW DO I ENROLL?
Human Resources will provide you with instruction on how to Enroll through this website. Please keep in mind that it is not necessary for you and/or your dependents to participate in all benefit plans offered. You will be given the opportunity to choose whether or not to participate in each plan for yourself and your eligible dependents. Also, please note that you must enroll yourself and your eligible dependents within a designated time frame that will be provided by Human Resources.
CHANGES IN STATUS
If you or your eligible dependents experience a “qualifying event” (birth, death, marriage, divorce, loss of coverage, etc.), please contact Human Resources immediately so that any required/requested changes
can be made within 30 days of the occurrence.
Leiter’s is offering you a choice of six (6) medical plans. The following charts show what you would pay for selected benefit features on the 6 plans offered. Please note that the $20 Kaiser Co-Pay HMO plan has not changed, the Kaiser Gold HMO has minor changes (e.g. office co-pay change from $35 to $30, etc.), and the Blue Shield HMO and PPO plans are replaced by UnitedHealthcare. For more complete descriptions (including out-of-network benefits), please refer to the Summaries of Plan Benefits.
Kaiser Gold 80 0/30
Kaiser $20 Co-Pay HMO
UnitedHealthcare Silver 2000 HMO
Blue Shield Platinum Full PPO 150
Blue Shield Gold Full PPO 0
Blue Shield Gold Full PPO 750
Blue Shield Silver Full PPO 1250
Group Dental insurance is provided for you and your dependents by Assurant Employee Benefits. With
the Assurant dental plan you are free to use the dentist of your choice. However, if you choose a dentist
within Assurant’s network you may save money. To find a dentist in your area, please visit Assurant’s
Online Advantage for Members. Costs of services rendered by out-of-network dentists are based on
Usual, Customary, and Reasonable limits. For a more complete description of coverage please refer to
Instructions to retrieve your Dental ID Card can be found here. First time users will need to register. In the registration process, you will need your member ID#. If you don't know your member ID#, please contact Baxter & Associates at (408) 249-5678 or at email@example.com.
YOUR 2016 DENTAL PLAN MONTHLY PREMIUM CONTRIBUTIONS
Leiter’s pays 100% of employee coverage, and you pay 100% of dependent cost as follows:
YOUR 2016 MEDICAL PLAN MONTHLY PREMIUM CONTRIBUTIONS
GOLD 80 0/35 HMO PLAN
You will pay a total of $60.00 per month for Employee Only coverage, deducted from payroll every 2
weeks on a pre-tax basis. Dependent coverage is available with employee paying 100% of the cost of
each dependent based on dependent’s age. Please refer here for monthly dependent rates.
$20 Copayment HMO Plan
You will pay a total of $121.83 per month for Employee Only coverage, deducted from payroll every 2
weeks on a pre-tax basis. Dependent coverage is available with employee paying 100% of cost. Please
refer here for monthly dependent rates.
Blue Shield HMO and PPO Plans
Please refer here for monthly employee and dependent rates.
Leiter’s provides you with vision care through VSP. Please refer to the Summary of Benefits for a more complete description of coverage.
YOUR 2016 VISION PLAN MONTHLY PREMIUM CONTRIBUTIONS
Leiter’s pays 100% of employee coverage, and you pay 100% of the dependent cost as follows:
Leiter’s provides eligible employees group life insurance. This benefit is for employees only and is paid 100% by Leiter’s Compounding. The amount of Life and AD&D (accidental death and dismemberment) is determined by employment class and is as follows:
Please note: The amount of death benefit reduces at age 65 to 65% and at age 70 to 50%.
HMO (888) 319-5999
PPO (800) 424-6521
Employee + Spouse
Employee + Child(ren)
Blue Shield of California
Please contact our broker, Vincent Baxter, with any questions regarding your benefits, eligibility, claims, etc. at (408) 249-5678 or email at LCRX@baxter95128.com.