Benefits Brochure 2017

2017 Summary of Employee Benefits24 1

For questions regarding benefits, please contact: Katie Harris Benefits Administrator at 629-3465 or [email protected] 23

Fitness Reimbursement Program Table of ContentsThe Summit Center is committed to encouraging our employee’s to lead an Insurance Carrier Information…………………..………………….……………4 active lifestyle. We have implemented a Fitness Reimbursement Program Medical Plan………………………………………………...……………….……….6-7 to motivate employees to make exercise a part of their regular routine by Health Reimbursement Account……………..…………………….………….8 Dental Plan…………………………………………………………………….………...9 attending any local fitness center. Vision Plan…………………………………………..……………...…………….10-11 Basic Life Insurance and AD&D Benefits………………...……………….12 HOW CAN I PARTICIPATE? Voluntary Life Insurance and AD&D Benefits…………..……………..13 New York State Statutory Disability…………………………….………....141. Obtain a membership at a fitness center of your choice. Long Term Disability…………………………………………………….………...152. Complete the Fitness Reimbursement Registration form found on MySummit Flexible Spending & Dependent Care Account…………………..16-173. Exercise at your fitness center a minimum of 8 times per month. 401(k) Plan……………………………………………………………………………..184. Obtain verification of your attendance from your gym on a monthly basis, and Employee Assistance Program………………………………………………..19 Pet Insurance………………………………………………………………………...20 return the report to HR. Employee Discounts……………………………………………………………….21 Fitness Reimbursement………………………………………………………...22 HOW WILL I RECEIVE REIMBURSEMENT? 3The Summit Center will provide a reimbursement of $20 per month.. You mustattend your gym at least 8 times per month in order to receive reimbursement. PAYMENT OCCURS DURING JANUARY, APRIL, JULY, & OCTOBER Track October, November, December to be paid out in January. Track January, February, March to be paid out in April. Track April, May, June to be paid out in July. Track July, August, September to be paid out in October. 22

Independent Health Employee Perkswww.independenthealth.comGroup # 32823 The Summit Center offers a variety discounted tickets/membershipsCustomer Service: 716-631-8701 for purchase in the Human Resources office including the following:  Regal movie ticketsHealth Reimbursement Account  AMC movie ticketsGroup # BCII55  Darien Lakewww.mywealthcareonline.com/myhnas  Martin’s Fantasy IslandCustomer Service—(800)518-8332  Erie County Fair  Delta SonicFlexible Spending/Dependent Care  Tim Horton’s gift cardsAccount  BJ’s Wholesale Club membershipsGroup # BCII55www.mywealthcareonline.com/myhnas HR is always looking for new ideas for employee incentives. If youCustomer Service—(800)518-8332 have a suggestion please email any member of HR.401(k) - Vanguard 21www.vanguard.com/retirementplansPlan # 097545Customer Service—(800)523-1188 4

Pet Insurance MetLife Dental Group # 5941621Pet insurance reimburses you for vet bills when your pet is sick or Customer Service—1-800-275-4638injured, to help take the financial worry out of vet visits.Employees receive up to a 10% discount for pet insurance. Rates MetLife Visionare based on breed and age. Group # 5941621Get an instant quote at: www.petsbest.com/summitpet or Customer Service—1-800-275-4638 call 888-984-8700 and reference code SUMMITPET MetLife Basic & Voluntary Life Group # 5941621 Customer Service—1-800-275-4638 ShelterPoint Short Term Disability Group # DBL496580 www.shelterpoint.com20 5

Medical Insurance Employee Assistance ProgramCoverage Cost per paycheck Annual Cost Phone—1-800-511-3920 Website—www.members.mhn.comSingle $5.00 $120.00Family $241.69 $5800.56 Company Code: metlifeeap1 Passport Plan Select– 32823 The Employee Assistance program is a free benefit providing guidance In-Network Benefits for personal issues that you might be facing and information about other concerns that affect your life, whether it’s a life event or on a day-to-dayDeductible $1,000/$2,000 basis.Out-of-pocket Max $3,000/$6,000Primary Office Visit $25 copay/visit EAP offers help with:Specialist Office Visit $25 copay/visitTelemedicine Program $10 copay/consultation Education: Dependent Care & Care Giving:Laboratory Testing $0 copay/visitEmergency Room Deductible then 20% coinsurance  Admissions testing & procedures  Adoption AssistanceAmbulance Deductible then 20% coinsuranceUrgent Care Center $75 copay/visit  Adult re-entry programs  Before/after school programsInpatient Hospital Deductible then 20% coinsuranceOutpatient Surgical Procedures 20% coinsurance  College planning  Day Care/Elder CareRoutine Radiology 20% coinsurancePhysician prenatal and postnatal $0 copay/visit Lifestyle & Fitness Management: Legal and Financial:Inpatient Maternity Delivery: Deductible then 20% coin-PT/OT/Speech 20% coinsurance  Anxiety & depression  Basic tax planningPrescription Drug Tiers $10/$30/$50  Divorce & separation  Credit & collectionsAdditional Benefits $250 Wellness card  Drugs & alcohol  Debt counseling  Home buying 6 Working Smarter:  Career development  Effective Managing 19

Medical Insurance 401(k) Coverage Cost per paycheck Annual Cost SingleEligibility 21+ years old Family $2.00 $48.00Deferral Amounts $150.00 $3600.00Annual Maximum 1—60% of salaryEmployer Match $18,000 iDirect 1 Series C– 32823Vesting Schedule Dollar for dollar up to 4% In-Network Benefits Employer Match—immediately Profit Sharing—3 years of service Deductible $1,500/$3,000 Out-of-pocket Max $5,000/$10,000At the discretion of the agency, a profit sharing contribution is made Primary Office Visit Deductible then $20 copay/visitto your 401(k) retirement account on an annual basis. To be eligible Specialist Office Visit Deductible then $20 copay/visit Telemedicine Program $10 copay/consultation you must be 21, complete 6 months and 1000 hours of service. Laboratory Testing Deductible then $0 copay/visit Emergency Room Deductible then $125 copay/visit Ambulance Deductible then $25 copay/trip Urgent Care Center Deductible $75 copay/visit Inpatient Hospital Deductible then $750 copay/admission Outpatient Surgical Procedures Deductible then $150 copay/visit Routine Radiology Deductible then $20 copay/visit Physician prenatal and postnatal care $0 copay/visit Inpatient Maternity Delivery: Deductible then $750 copay PT/OT/Speech Deductible then $15 copay/visit Prescription Drug Tiers $10/$30/$75 Additional Benefits $250 Wellness card 18 7

Health Reimbursement Account Flexible Spending Account Group BCII55 Employees can choose to make pre-tax deductions out of their paycheckCoverage Amount to pay for unreimbursed medical expensesSingle iDirect $750 What your Benefits FSASingle Passport $375 Cover: Maximum $2600 plan yearFamily iDirect $1500Family Passport $750 AmountEmployees who enroll in Summit’s Independent Health medical Rollover Up to $500 of funds can rollover in to the nextplan will automatically receive a Health Reimbursement Account Contributions plan year. Anything above that amount will be(HRA) administered by HealthNow Administrative Services forfeited Employees will receive a debit card that can be used for out of Employee makes contributions each paycheck pocket medical expenses—prescriptions, copays, etc. but total dollar amount is received up front . Unused funds rollover into next year Save your receipts—you may need to verify your purchases as per IRS regulations 8 17

Dependent Care Spending Account Dental Insurance Employees can choose to make pre-tax deductions out of their Coverage PDP Plus Network paycheck to pay for daycare expenses Single Family Cost per paycheck Annual CostWhat your Benefits Cover: Dependent Care Services FREE FREE $19.25 $462.00Amount Annual maximum $5000 Group #5941621 Out-of-networkRolloverContributions Unused funds do not rollover In-network Must contribute to the plan before re- questing reimbursement Preventive Services 100% 100% (Cleanings, Basic care (Fillings, periodon- 90% 80% tal maintenance, root canal) 50%*Daycare provider must have a tax ID number Major Care (bridges, den- 60% tures, single crowns) 50% 50% $50—single Orthodontia (lifetime max $150—family $1,250 Deductible None 26 Annual Maximum Benefit Dependent Age Limit 16 9

Vision Insurance—High OptionCoverage Group #5941621 Long-Term Disability Cost per paycheck Annual Cost Employer provided benefit for all full time employees—no cost to employees. What your Benefits Long-Term DisabilitySingle $5.30 $127.20Family $12.45 $298.80 Coverage Amount 66.7% of salary to maximum $4000/monthServices In-network Benefits Benefits Begin After day 181 of being disabledExams Copay $10 copay Pre-existing conditions A pre-existing condition includes any condition/Single Vision, bifocal, Covered in full after $10 eyewear copay symptom for which you, in the specified timetrifocal and lenticular period prior to coverage in this plan, consulted $130 Allowance after $10 eyewear copay with a physician, received treatment, or tookFrames *You will receive an additional 20% savings prescribed drugs. on the amount you pay over your allow- 3 Months look back; 12 months after limitationContact Lenses $130 Allowance *You will receive benefit payments while you are unable to work in your job Typically employees are on Short-term disability prior to receiving LTD benefitsContact lens fitting Covered in full with max copay of $60Service Frequencies Every calendar year 10 15

Short-Term Disability Vision Insurance—Low OptionEmployer provided benefit for all employees—no cost to employees. Group #5941621 Coverage Cost per paycheck Annual CostWhat your Benefits Cov- Short-term Disability Single $3.38 $81.12Coverage Amount 50% of earnings up to $170/week for 26 Family $7.94 $190.56Benefits Begin After day 7 of being disabled Services In-network Benefits*You will receive benefit payments while you are unable to work in your job Exams Copay $20 copay Single Vision, bifocal, Covered in full after $20 eyewear copay trifocal and lenticular $100 Allowance after $20 eyewear copay Frames *You will receive an additional 20% savings on the amount you pay over your allow- Contact Lenses $100 Allowance Contact lens fitting Covered in full with max copay of $60 Service Frequencies Every calendar year 14 11

Basic Life and AD&D Voluntary Term LifeEmployer provided benefit for all full time employees—no cost to em- Cost is based on employee’s age and volume of life insurance ployees. What your Benefits Cover: Voluntary Term LifeWhat your Benefits Cover: Basic LifeEmployee Benefit 150% of your annual salary, to a max of Employee Benefit $10,000 increments to a maximum of $200,000Accidental Death and Dis- Accidental Death and Dis- Enhanced employee, spouse, and child(ren)memberment Basic life coverage includes Accidental Death and Dismemberment coverage equal to one memberment coverage. Maximum 1 times life amount times to employee’s life benefits. Spouse/Domestic Partner $5,000 increments to a maximum ofGuarantee Issue You are not required to answer health ques- Benefit $100,000 tions to qualify for coverage. Child Benefit Your dependent children age 14 days to 20 years (26 if full time student) $1,000 incre- ments to a maximum of $10,000. 12 13