2019 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 Leiters.

 

- 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.

 

 Medical Plans

Leiters offers you a choice of seven (7) medical plans.  The following charts show what you would pay for selected benefit features on the 7 plans offered.   For more complete descriptions (including out-of-network benefits), please refer to the Summaries of Plan Benefits.

 

 

Please Note: PPO plans are available inside and outside California.  HMO plans (with the exception of the Colorado Kaiser plan) are available to California residents only.  The Kaiser Colorado plan is available to residents of select Colorado counties only.

HMO PLANS (CALIFORNIA ONLY)

PPO PLANS (ALL STATES)

Benefit Features

Kaiser Gold 80 0/25

HMO

Kaiser $20 Co-Pay HMO

UnitedHealthcare Silver 2250 HMO

Benefit Features

UnitedHealthcare Platinum PPO $0 Deductible

UnitedHealthcare Gold PPO $500 Deductible

UnitedHealthcare Silver PPO $1,500 Deductible

COLORADO HMO PLAN (COLORADO RESIDENTS ONLY)

Benefit Features

Kaiser Colorado Platinum 0/20 HMO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOUR 2018 MEDICAL PLAN MONTHLY PREMIUM CONTRIBUTIONS

 

 

 

GOLD 80 0/25 HMO PLAN

You will pay a total of $99.00 per month for Employee Only coverage, deducted from payroll every 2 weeks on a pre-tax basis.  Dependent coverage is available with Leiters paying 25% 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 $163.16 per month for Employee Only coverage, deducted

from payroll every 2 weeks on a pre-tax basis.  Dependent coverage is available

with Leiters paying 11% of the cost.  Please refer here for monthly dependent rates. 

 

 

UnitedHealthcare HMO and PPO Plans

Please refer  here  for monthly employee and dependent rates.  Leiters pays 25%

of the dependent cost.

 

 

 

Colorado Kaiser Platinum 0/20 HMO

This plan is for Colorado residents only.  You will pay a total of $99.00 per month for Employee Only Coverage, deducted from payroll every two weeks on a pre-tax basis. Dependent coverage is available with Leiters paying 25% of the cost of each dependent based on dependent's age.  Please refer here for monthly

dependent rates.

 

   Please Note: Leiters contribution to dependent coverage is already factored into all medical plan

   rate grids

 

 

   

 

   Dental Plan

 

Group Dental insurance is provided for you and your dependents by Dental Select Employee Benefits. With the Dental Select dental plan you are free to use the dentist of your choice.  However, if you choose a dentist within Dental Select's network you may save money.  To find a dentist in your area, please visit Dental Select.  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 the Summary of Plan Benefits.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOUR 2018 DENTAL PLAN MONTHLY PREMIUM CONTRIBUTIONS

 

You will pay $12.00 per month for employee only coverage, deducted from payroll every 2 weeks on a

pre-tax basis. Leiters will pay 25% of the dependent coverage which is factored into the following rates:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOUR 2018 VISION PLAN MONTHLY PREMIUM CONTRIBUTIONS

 

You will pay $1.50 per month for employee only coverage, deducted from payroll every 2 weeks on a pre-tax basis. Leiters will pay 25% of the dependent cost, which is factored into the following rates:

 

 

 

 

 

 

 

 

 

     Life Insurance/AD&D

 

 

 

Leiters provides eligible employees group life insurance.  This benefit is for employees only and is paid 100% by Leiters.  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%.

 
   
    Flexible Spending Account (FSA)

 

 

You have the opportunity to enroll in Leiters  FSA for healthcare and dependent

care.  An FSA is a payroll deduction plan that allows you to put aside a portion of

your earnings to pay for HealthCare and/or Dependent care on a pre-tax basis. 

You may elect up to $2,650 per year for healthcare and up to $5,000 per year for dependent care. Please refer here for more information.  Please refer to a Sample

of Eligible Expenses for the HealthCare FSA here.

 

    Legal Service Plan and Identity Theft Plans

   

 

By enrolling in and becoming a member of LegalShield's legal service plan, you can access legal counsel and advice from qualified lawyers simply by calling a

toll-free number.  Also, you may enroll in a choice of LegalShield's identity theft

plans. Please refer here for more information and to subscribe directly to

LegalShield.

 

   

   Contact Information

 

 

 

    Vision Care

 

 

 

Leiters provides you with vision care through VSP.  Please refer to the Summary

of Benefits for a more complete description of coverage.

$1.50

 

$4.20

 

$4.35

 

$8.93

Employee Only

 

Employee + Spouse

 

Employee + Child(ren)

 

Family

Kaiser Permanente
United Healthcare
Dental Select
VSP
UNUM

(800) 464-4000                                 

 

 

HMO (800) 624-8822                        

 

PPO (866) 633-2446

 

 

(800) 999-9789              

 

 

(800) 877-7195                                 

 

 

(866) 679-3054                                 

Website

 

 

Website

 

 

 

 

Website

 

 

Website

 

 

Website

Broker

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.

Call us today on (408) 249-5678

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