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Enrollment checklist

PREPARE FOR ENROLLMENT

This enrollment checklist is designed to help you make informed enrollment decisions during benefits enrollment.

 

You must enroll in each plan, or else you will be waiving coverage for each plan offered. Go to Enrollment Information for instructions.

Benefits Information Review

Review your current benefits 

Medical Plans

STANDARD or WELLNESS PLAN

  • The Standard Plan is an EPO plan with annual deductibles of $2,750 / $4,250 and out-of-pocket maximums of $7,150 / $14,300 

  • The Wellness Plan is a PPO plan with reduced annual deductibles of $1,750 / $3,250 and out-of-pocket maximums of $7,150 / $14,300

    • Both plans offer a Health Reimbursement Account (HRA) 

    • Knight funds the HRA, but the funds are only available after completing Wellness Program incentives 

    • The rates are the same for both plans, but Wellness Program incentives must be completed to avoid surcharges on the Wellness Plan (see pages 8-10 for an explanation of the Wellness Program)

PROSANO PLAN - NEW FOR EMPLOYEES RESIDING IN ARIZONA

  • The Prosano Plan is a PPO plan with annual deductibles of $2,500/$5,000 and out-of-pocket maximum of $6,500/$13,000

  • The Prosano Plan is available to Arizona residents only and offers zero cost shares on a number of services performed at or by Prosano Health Advanced Primary Care Centers (Prosano Health) 

 

You must elect a Medical plan or else you will be waiving coverage for the year

Dental & Vision Plans

DENTAL: DELTA DENTAL STANDARD or PREMIUM PLAN 

  • The Standard plan offers $1500 coverage and the Premium plan offers $2500 coverage 

  • Major dental services are covered 50% with the Standard plan and 80% with the Premium plan 

  • Standard Plan Ortho: 50% up to $1,000 (Children Only) Premium Plan Ortho: 50% up to $2,000 (Children & Adults)

VISION: EYEMED PLAN 

  • With EyeMed, staying in-network helps you save money on eye exams, frames and lenses

    • Visiting a PLUS Provider helps you save even more, like a $0 copay of exams, frames, and contacts  

 

You must elect a Dental and Vision plan or else you will be waiving coverage for the year

Flexible Spending Accounts

HEALTH CARE (FSA) and/or DEPENDENT CARE (DCFSA) FLEXIBLE SPENDING ACCOUNTS  

  • The Health Care FSA has an annual limit of $3,200 with a potential annual tax savings of $950 

  • The Dependent Care DCFSA has an annual limit of $5,000 with a potential annual tax savings of $1,500 

You must elect the FSA and/or DCFSA or else you will be waiving coverage

Voluntary Benefits

HOSPITAL INDEMNITY / ACCIDENT / CRITICAL ILLNESS INSURANCE   

  • These voluntary benefits are designed to help employees pay for medical bills and other out-of-pocket expenses that often arise after unexpected injuries and illnesses and coverage is available for you, your spouse and your children 

  • Benefit payments come directly to you without restrictions on how you can use them (See pages 20-22 for details) 

You must elect coverage for each or else you will be waiving coverage for the year for each benefit

Life and AD&D

TERM LIFE | ACCIDENTAL DEATH & DISMEMBERMENT (AD&D)    

  • Term Life | AD&D is provided by Knight (Supplemental coverage for you, your spouse and children is available)

    • Driving Associates receive 1x Basic Annual Earnings; subject to a minimum of $25,000 and a maximum of $52,000 (value may decrease after age 65) 

    • Non-Driver Associates receive 1x Annual Earnings up to a maximum of $300,000 (value may decrease after age 65) 

You must elect Life/AD&D or else you will be waiving coverage for the year

Disability

SHORT-TERM DISABILITY (STD) & LONG-TERM DISABILITY (LTD)

  • Short- and Long-Term Disability is provided by Knight (both are voluntary)

    • STD - Driving Associates coverage amount is 50% of your monthly earnings to a maximum benefit of $600/week 

    • STD - Non-Driver Associates coverage amount is 60% of your monthly earnings to a maximum benefit of $1,000/week 

    • LTD - Driving Associates coverage amount is 50% of your monthly earnings to a maximum benefit of $5,000/month 

    • LTD - Non-Driver Associates coverage amount is 60% of your monthly earnings to a maximum benefit of $5,000/month 

You must elect Short-Term and/or Long-Term Disability, or else you will be waiving coverage for the year

COMPLETING ENROLLMENT

REVIEW AND SUBMIT CHOICES IN SELERIX ESS

  • Please ensure that spouses and dependents have been properly added 
  • Double check your main address in ESS, this is the address your ID cards will be sent to. See page 31. 

DONE!

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