Summary of Benefits
For Exempt
and Office Employees
Health Care Insurance
Provider: CoreSource
Eligibility: 1st day of the month following 90 days
of employment.
| |
EPO |
PPO |
| |
|
In
Network |
Out
of Network |
| Office Copay |
$20.00 |
n/a |
n/a |
| Specialist Copay |
$35.00 |
n/a |
n/a |
| Coinsurance |
100% |
75% |
50% |
| Employee Deductible |
$0.00 |
$400.00 |
$400.00 |
| Family Deductible |
$0.00 |
$800.00 |
$800.00 |
| Employee Out-of-Pocket |
n/a |
$2500.00 |
n/a |
| Family Out-of-Pocket |
n/a |
$7500.00 |
n/a |
| Inpatient Hospital Copay |
$500.00 |
n/a |
n/a |
| Outpatient Surgery Copay |
$200.00 |
n/a |
n/a |
| ER Copay |
$75.00 |
$75.00 |
n/a |
| Urgent Care Copay |
$35.00 |
n/a |
n/a |
| Lifetime Max |
$2,000,000.00 |
$2,000,000.00 |
$1,000,000.00 |
RX Drugs |
|
|
|
| Generics |
$10.00 |
$15.00 |
Subject to
Deductible and Coinsurance |
| Brand-Formulary |
$20.00 |
$25.00 |
Subject to
Deductible and Coinsurance |
| Brand-Non Formulary |
$50.00 |
$50.00 |
Subject to
Deductible and Coinsurance |
| Mail Order (90 day
supply) |
2.5 times retail |
2.5 times retail |
Subject to
Deductible and Coinsurance |
Dental
Insurance
Provider: MetLife
Eligibility: 1st day of the month following 90 days
of employment
| Annual Deductible |
$50.00/$100.00 |
| Preventative |
100% |
| Exam, Cleaning, X-Rays |
100% |
| Basic |
80% |
| Endodontics |
80% |
| Periodontics |
80% |
| Major - Crown, Bridges |
50% |
| Calendar Year Max |
$1000.00 |
| |
|
| Orthodontia (children only) |
50% |
| Deductible |
n/a |
| Lifetime Max |
$1000.00 |
Vision
Insurance
Provider: Vision Service Plan (VSP)
Participants must utilize a VSP provider
Participant co-payments: $10.00 for Exam
$25.00 for Materials
Exams, lenses, and frames are paid-in-full after co-payment
is met.
Voluntary
Life Insurance and AD&D, Critical Illness Insurance,
Accident Insurance, Short Term Disability and Long Term
Disability
Provider: Unum
Eligibility: The next special enrollment period after
the 1st day of the month following 90 days of employment.
Cost: Employee pays the entire premium and depends on
the number of units purchased, age and other factors.
Spouse and dependant coverage is available for Life,
AD&D and Accident Insurance.
Basic Life
Insurance and AD&D
At no cost to you, Harlan Bakeries automatically provides
basic term life insurance and accidental death and dismemberment
insurance effective the 1st of the month following 90
days of employment. For exempt employees, coverage equals
1.5 times your basic annual earnings up to $400,000.00.
For non-exempt employees, coverage is $10,000.00
Short Term
Disability Insurance
At no cost to you, Harlan Bakeries provides a weekly
benefit to replace a portion of your income effective
the 1st of the month following 90 days of employment.
The weekly benefit amount is 60% of your pay, the maximum
benefit period is 13 weeks and benefits begin on the
1st day of an accident and on the 8th day for sickness.
Long Term
Disability Insurance
At no cost to you, Harlan Bakeries provides a benefit
if your disability continues beyond the STD period.
The monthly benefit amount is 60% of monthly earnings
up to a maximum benefit of $10,000.00 per month.
Employee
Assistance Program
At no cost to you, Harlan Bakeries provides you with
an employee assistance program. This program can help
you find solutions for the everyday challenges of work
and home as well as more serious issues involving emotional
and physical well being. Services include telephone
consultation, personalized searches and referrals, online
resources, online financial calculators, face-to-face
consultations, education materials and all types of
counseling, including family counseling.
401K Program
Eligibility: 90 days of employment and 18 years of age.
Enrollments: January, April, July, and October.
Harlan Bakeries, Inc. will match employee contributions
$.50 for every $1.00 the
employee saves up to 6% of their annual salary for the
year 2006. The match is
discretionary and is determined by Harlan Bakeries,
Inc. each year.
Vacation
Policy
1-4 years will accrue 10 per year, after 4 years of
service one day is added for each year of service.
Personal
Days
Full-time employees are granted 4 paid days off each
year. Personal time accrues
each pay period.
Paid Holidays
Thanksgiving Day
1/2 day Christmas Eve
Christmas Day
Memorial Day
Independence Day
Labor Day
1/2 day New Years Eve
New Years Day
This is a summary of benefits
only, it is subject to change at any time for any
reason, Group Policies alone determine all rights and
benefits.
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