U.S. Toy Company 2016 Benefits Guide

SINCE 1953

COMPANY

2016 Employee Benefits Guide

Where

learning
meets fun!

Eligibility

Benefit Eligibility How to Enroll

For those who are eligible for benefits, we have many It’s now time to enroll in your benefits! You must
great options for you to choose from! The benefit complete your 2016 Online enrollment by the
program for 2016 includes: designated due date or you will not be able to
enroll until the next Open Enrollment period
• Medical and Prescription Drug Coverage or if you have a qualifying life event. Even if
you do not want any benefits, we need you to
• Dental Coverage complete the 2016 Online enrollment and decline
coverage.
• Vision Coverage
Remember:
• Basic Life and Accidental Death and Dismemberment The plan year starts
every April 1st
• Voluntary Life Insurance

• Long-Term Disability

EMPLOYEES

Full-time team members are eligible for coverage under
the benefit plans the first of the month following 60 days
of employment. If you do not enroll when you become
eligible, you will not be able to enroll until the next Open
Enrollment period or unless you have a qualifying life
event during the year.

DEPENDENTS

Only dependents who meet the definition of an eligible
dependent can be enrolled in a U.S. Toy Company
benefit plan. Eligible dependents include the following:

• Legal spouse

• Children*

• Biological

• Adopted

• Any child you support who lives with you in a
parent-child relationship and for whom you are
the legal guardian

• Disabled children of any age who are (or become)
physically or mentally incapable of self-support
while covered by our employee benefits program

Qualified Life Events

You are allowed to make changes once a year during the Open Enrollment period, or when you are initially eligible
for coverage. You cannot enroll, change or terminate your coverage during the plan year unless you have a change in
status, called a qualified life event (QLE), as defined by the Internal Revenue Service (IRS). Election changes must be
consistent with your status change. When in doubt if you are experiencing a QLE, refer to the plan document or ask
Human Resources. You must notify Human Resources and provide proper documentation within 30 days of the QLE
in order to make changes to your coverage. Otherwise, changes cannot be made until the next Open Enrollment.

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What Does that Word Mean?

We admit it. Benefits can be difficult to understand. Here are some common benefit words and their definitions to help
you as you read through this guide.

TERM DEFINITION
Annual Deductible
The amount you are required to pay each calendar year before certain benefits are paid
for by the plan. Once you meet the deductible amount, expenses are covered by the plan
based on the coinsurance percentage.

Annual Out-of- The most you pay in a calendar year for covered services that are subject to coinsurance/
Pocket Maximum copays. The deductible is included in this amount. If you reach the annual out-of-pocket
maximum, the plan pays 100% of covered in-network eligible expenses for the remainder of
the plan year. Office visits and prescription copays are included in the annual out-of-pocket
maximum for our medical plans.

Balance Billing When you are billed for the difference between the provider’s actual charge and the
amount reimbursed under the medical or dental plan. This occurs when you go outside of
the preferred provider network.

Coinsurance The percentage the insurance company will pay.

Copayments or The flat dollar amount you pay for certain in-network services.
Copays

Explanation of Provides information about how your claim was processed by the insurance company. The
Benefits (EOB) EOB details what portion of the claim was paid by the insurance company and what portion
In-Network is your responsibility.

A group of doctors, hospitals and other healthcare providers that contract with a plan
vendor to provide quality healthcare services at favorable rates.

Plan Year The plan year refers to January 1, 2016 to December 31, 2016.

Preferred Provider A healthcare arrangement designed to provide healthcare services at a discounted cost for
Organization (PPO) members to use designated providers (the network), but which also provides coverage (at a
lower level) for services received from providers that are not part of the network.

Usual, Customary, UCR charges are determined by your health plan vendor and are based on the range of
and Reasonable fees charged by doctors with comparable training and experience for the same or similar
(UCR) Charges service in your area. When you receive in-network care, UCR charges do not apply. You are
responsible for amounts over UCR for out-of-network care.

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Enrollment

During a benefits elections enrollment, you are given the opportunity to update your
dependents, beneficiaries, and benefit elections offered through U.S. Toy Company.

Sign in through www.paycor.com & hover over Payroll, then select “My Information”

Open the Company menu on the left, and select “Benefit Elections”
Your current enrolled, waived, and past benefit elections will be displayed here
If there is an enrollment in progress, click the link at the top of the screen
This will open your enrollment event, proceed through each of the screens

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Medical Plan Comparisons

HDHP $5,000 W/HSA PPO $1,500

In-Network Out-of-Network In-Network Out-of-Network

Lifetime Maximum Unlimited Unlimited

Calendar Year Deductible

Individual/Family $5,000/$10,000 $10,000/$20,000 $1,500/$3,000 $3,000/$6,000

Out-of-Pocket Maximum

Individual/Family $5,000/$10,000 $7,000/$14,000 $3,000/$6,000 $9,000/$18,000
(Includes Deductible)

Physician Services

Office Visits 100% after deductible 50% after deductible $25 copay 50% after deductible

Specialist 100% after deductible 50% after deductible $25 copay 50% after deductible

Preventive Care No Charge 50% after deductible No Charge 50% after deductible

Urgent Care 100% after deductible 50% after deductible $50 copay 50% after deductible
Hospital Services
Inpatient Surgery 100% after deductible 50% after deductible 80% after deductible 50% after deductible

Outpatient Surgery 100% after deductible 50% after deductible 80% after deductible 50% after deductible

Emergency Room 100% after deductible $150 copay
Radiology and Complex Imaging

X-Rays 100% after deductible 50% after deductible 80% after deductible. 50% after deductible

Complex Imaging 100% after deductible 50% after deductible 80% after deductible 50% after deductible
(CT, PET, MRI, etc.)
Prescription Drugs 100% after deductible $5/25/40/65 in-network copay +
Retail (Out-of-network benefits not covered) balance bill

Retail (30 day)

WHO PAYS WHAT?

Cost Per Pay Period (26) HDHP $5,000 HDHP $5,000 PPO $1,500 PPO $1,500
Employer Contribution Employee Contribution Employer Contribution Employee Contribution

Employee $138.15 $27.72 $160.14 $64.58

Employee and Spouse $240.75 $107.58 $244.57 $227.37

Employee and Child(ren) $218.44 $96.72 $221.42 $205.56
Employee and Family $323.52 $174.10 $293.23 $380.96

Important Information Regarding Preventive Medications for HSA Plan Participants

This plan includes preventive medications at no cost to you, they are not subject to your plan deductible. Preventive
medications are those prescribed to prevent the occurrence of a disease or condition for those individuals with risk factors, or
to prevent the recurrence of a disease or condition for those who have recovered, and do not include medications used to treat

an existing illness, injury or condition. Please refer to the Cigna Preventive Drug listing for more information and a listing of
medications available under this program

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High Deductible Health Plan

What is a Health Savings Account (HSA)?

A Health Savings Account is a special, tax-advantaged, interest bearing account to help plan and pay
for qualified health care expenses (including plan deductible) while covered by the U.S. Toy Company’s
high deductible health plan (HDHP-3000)

What are some advantages to an HSA? Who is eligible for an HSA?

1. Unused money rolls over from year to year in an Anyone who is:

interest-bearing savings account • Covered by U.S. Toy Company’s qualified high

2. No “use it or lose it” rule deductible health plan (HDHP-3000)

3. Tax benefits: • Not covered under another medical plan that is

• HSA contributions are excluded from federal not HSA compatible
income tax
• Not enrolled in Medicare, Medicaid or Tri-Care
• HSA growth is tax-deferred or have received VA benefits in the last three
months
4. HSA funds can be used for your eligible expenses as
well as any tax dependent you have even if they are • Not eligible to be claimed as a dependent on
not covered under your health plan someone else’s tax return such as a dependent
child claimed by their parents
5. Withdrawals for eligible expenses are exempt from

federal income tax How much can I contribute to an HSA?

Examples of Eligible Expenses • Contributions may not exceed $3,350 for

• Medical Deductible individual coverage and $6,750 for employee

• Prescription drugs with dependent(s) coverage annually on a pre-

• Blood sugar test kits/test strips tax basis for the 2016 tax year. This amount

• Crutches includes any contributions received from your
• Braces employer
• Hearing aids
• Vision expenses • Individuals age 55 and older are eligible to make
catch-up contributions of an additional $1,000
• Dental services annually

For a complete listing of the IRS allowable expenses, Today Future
you can visit www.irs.gov/pub/irs-pdf/p502.pdf
Pay for qualified Plan for the future
HSA Account expenses with tax and retiree health-
• You own your HSA free dollars related costs
• Contribute tax free & reduce your

taxable income High Deductible Health Plan

• You choose how and when to use your • Preventative Care covered at 100%, not
dollars subject to deductible

• Unused money accumulates each year • You pay 100% of the contracted rate until
the deductible is met, then only pay a share
• Earns interest, tax deferred

of the costs

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Dental

We offer you and your eligible dependents a dental plan through Cigna. The PPO network gives you
access to a nationwide network of dentists that provide treatment at a negotiated rate. You may seek
dental care from any provider; however, your out-of-pocket expenses will be lower if care is provided
by a dentist in the Cigna network. Out-of-network providers can also balance bill you for services. To
locate a provider participating in the network, visit www.cigna.com

CIGNA DENTAL PLAN WHO PAYS WHAT?

In-Network Out-of-Network* Pay Period Cost Employee

Plan Year Deductible $50/$150 $50/$150 Employee $11.47
Individual/Family
Plan Year Maximum Benefit $1,000 per person Employee and Spouse $22.66
Preventive and Diagnostic
(Deductible Waived) 100% 100% Employee and Child(ren) $27.61

Routine cleanings, X-rays, fluoride,- Employee and Family $42.72
sealants, etc.
Basic Services 80% 80% In-Network: Benefits are based on a negotiated
50% 50% contracted fee schedule, and there is no balance billing.
Fillings, root canal, oral surgery,
periodontics, etc. *Out-of-Network: Benefits are based on “Usual,
Major Services Customary, and Reasonable” (UCR) rates for a given
area, and providers can balance bill you for amounts
Crowns, dentures, bridges, partials, over the UCR rate.
rebase/reline, etc.

Out-of-Network Reimbursement MAC

Network DPPO

Vision

We offer vision coverage through Cigna. As shown in the chart below, you receive the highest level of
benefits under the plan and pay less out-of-pocket when you visit a network provider. You do have the
option to go outside of the network, but you will pay more for those services. Out-of-network providers
will require payment in full and then you must submit a claim to Cigna for partial reimbursement.

CIGNA VISION PLAN

In-Network Out-of-Network
Reimbursed up to $45
Eye Exams (Every 12 Months) $15 Copay
Reimbursed up to $32
Glasses Reimbursed up to $55
Reimbursed up to $65
Single $15 copay WHO PAYS WHAT?
Reimbursed up to $35
Lined Bifocal $15 copay Pay Period Cost Employee
Reimbursed up to $210
Lined Trifocals $15 copay Reimbursed up to $105 Employee $2.72

Frames (Every 12 Months) $130 Retail Allowance Employee + Spouse $4.97
+
Employee + Child(ren) $5.01
20% off balance

Contact Lenses (Every 12 Months) Employee + Family $7.73

Medically Necessary $15 copay

Elective $130 allowance

Frames $130 allowance Reimbursed up t $71

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Life and Accidental Death &
Dismemberment (AD&D) Insurance

Employer-Paid Life and AD&D Optional Life and AD&D

It’s important that our employees have some level of We provide all eligible employees the option of purchasing
financial protection. That’s why we provide eligible additional Life and AD&D insurance through UNUM. These
employees with Basic Life and AD&D coverage through benefits provide valuable peace of mind and gives you the
UNUM at no cost to you. All eligible employees receive option of covering your dependents.
guaranteed coverage in the amount of 1 and 1/2 times
your salary. If you elect coverage for yourself, you are eligible to elect
coverage for your spouse or dependent children as well.
You must designate a beneficiary for your benefits for employee You cannot elect Optional Life and AD&D for your spouse
Life and AD&D coverage. You have the right to change the and dependent children unless you elect coverage for
beneficiary at any time by written or electronic notice. You can yourself.
change your beneficiary by contacting Human Resources.

What is Guarantee Issue?

A “guarantee issue” amount is the dollar amount of coverage you can be approved for without completing a health
questionnaire. Guarantee issue amounts only apply during the 31 days following your initial eligibility period. If you wish to
enroll in the Optional Life and AD&D plan or increase your coverage after your initial eligibility period, you will be required to
complete the Evidence of Insurability Form, which contains questions about your health. Rates are based on your age and the

amount of coverage you elect. See Human Resources for additional details.

Employee • 5x annual earnings to $500,000 maximum
• Increments of $10,000
Dependent Spouse • 100% of employee amount not to exceed $500,000
• Increments of $5,000
Dependent Child(ren) • Birth to 6 months: $1,000
• 6 months to 19 (26 if full-time student): $10,000
Guarantee Issue • Increments of $2,000
Employee:
Spouse: • $150,000
Child(ren): • $25,000
• $10,000

Voluntary LTD & STD

Voluntary Short-Term Disability Insurance Voluntary Long-Term Disability Insurance

Short-Term Disability (STD) provides income protection Long-Term Disability (LTD) Provides income protection
for disabilities that occur due to injury or sickness and last against a long-term injury or sickness that extends beyond
for a short period of time. the period covered by the short term disability plan.

• Benefits begin on the 8th day for disability due to • Benefits begin on the 91st day for disability due to
injury or sickness injury or sickness

• Covers up to 60% of earnings to a maximum of • Covers up to 60% of earnings to a maximum of
$1,000/week $10,000/month

• Benefits are payable for up to 12 weeks • Benefits are payable to a Social Security Normal
Retirement Age

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Critical Illness Insurance

Could your bank account survive a serious illness?

How can Critical Illness Insurance Key Advantage
Help?
• You can use this coverage more than
• Critical illness insurance can pay a lump once. If you receive a full benefit payout
sum benefit at the diagnosis of a critical for a covered illness, your coverage can
illness. You can choose the level of be continued for the remaining covered
coverage from $5,000 to $50,000 - and conditions. The diagnosis of a new
you can use the money any way you see covered illness must occur at least 90
fit days after the most recent diagnosis and
be medically unrelated. Each condition is
Who is at risk? payable once per lifetime

• The odds of developing cancer during a Wellness Benefit:
lifetime are 1 in 2 for men and 1 in 3 for
women Based on the plan selected, this benefit
can pay $50 per calendar year per insured
• Every 34 seconds, someone in America individual if a covered health screening test is
will have a coronary event performed, including:

Who is eligible? • Blood Tests • Chest X-rays

• Active Employees • Stress Tests • Mammograms

• Dependent Child(ren) - up until age 26 • Colonoscopy

• Spouses age 17 - 64

Accident Insurance

If you have an accident, could it hurt your bank account too?

Who is at risk? Benefits that pay for covered accidents

• Every 10 minutes, over 750 Americans while you are the road to recovery
suffer an injury sever enough to seek
medical help Unum’s coverage provides a lump sum benefit
based on the type of injury (or covered incident)
• Nearly three times as many injuries you sustain or the type of treatment you need.
requiring medical attention happen off Here are some examples of covered injuries:
the job rather than at work
• Broken Bones • Eye Injury
Who is eligible?
• Burns • Ruptured Discs
• Active Employees
• Dependent Child(ren) - up until age 26 • Torn Ligaments • Concussion
• Spouses age 17 - 64
• Lacerations • Coma Due to a
Covered Injury

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401(k) at U.S. Toy Company

What is a 401(k) Anyway?

Simply put, a 401(k) is a type of retirement plan offered through your workplace. U.S. Toy offers a 401(k) plan for their
employees. Here are a few reasons why you should consider participating:
• Beyond providing a way to invest for retirement, 401(k)s may offer huge tax advantages. For example, your

contribution comes out of your paycheck before income taxes are deducted, which means your tax bill will be lower.
you could also save on taxes when you withdraw the money because you may be in a lower tax bracket in retirement.
• Through a 401(k), you will have the opportunity to get “free” money from your employer in the form of matching
contributions.
• Your retirement plan isn’t just a generic or glorified savings plan for your day-today expenses. It is a long-term,
personal plan for growing your savings by investing in a mix of mutual funds, stocks, and bonds.
• You can make adjustments along the way! We have a broker, Two West Advisors, who are here to help make any
changes to your plan to reflect your unique goals and needs from day one through retirement. If you are interested in
meeting with them, please let the HR Manager know and we will schedule an appointment.

Eligibility Requirements:

• Employees must complete 2 months of service

• You must be at least 18 years of age

Enrollment Process:

• If you are an eligible employee, you will automatically be enrolled at 3% contribution rate

• To make changes to the amount, or to Opt-Out of the automatic contribution, you must register and log into your
account at www.401k.com or call Fidelity at (800) 890-4015

• You should also receive information in the mail from Fidelity prior to your eligibility taking effect

U.S. Toy’s Contribution:

• U.S. Toy Company participates in an employer match contribution for their eligible employees. After completing 1

year of service, U.S. Toy will match 50% of your contribution amount up to 6%

What Else Does Fidelity Offer?

• Fidelity offers a great tool called “Full View”. It is a personal finance program that can be used to manage
your assets, income, expenses, loans, real estate and reward points. You can also use Full View to monitor
your budget goals and receive customized alert notifications

Vesting Period Years of Service Contribution Percentage

Less than 2 0%
2 25%
3 50%
4 75%
5 100%

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Additional Benefits

Additional Employee Benefits: Paid Time Off:

• Gift cards to celebrate birthdays • Regular full-time team members are eligible for PTO
• 35% discount of purchases at the retail stores benefits. PTO banks are input each January. The amount
loaded is associated to the employees’ tenure at the
(after 30 days of employment) start of the calendar year. For example, if an employee
• Annual company outings started in May 2010, their tenure would be 6 years in
• Treat wagon Wednesdays 2016 and would receive 172 hours of PTO.
• Education Reimbursement Program
• The third Thursday of each month will be a day to • Hourly employees have the ability to rollover up to 40
hours from year to year, but it must be used in the first
appreciate employees and have some fun! quarter of the following year or it will be lost.

Length of Employment Bank hours per year Number of
days per year
After 90 days...
52.00 hours 6.5
1 year...
92.00 hours 11.5
2-4 years...
132.00 hours 16.5
5-14 years...
172.00 hours 21.5
15 years and over...
212.00 hours 26.5

U.S. Toy Wellness Program

What is a Wellness Program?

Wellness programs include activities such as company-sponsored exercise, weight-loss
competitions, educational seminars, tobacco-cessation programs and health screenings that are
designed to help employees eat better, lose weight and improve their overall physical health.

Exciting Wellness Program Activities Why Participate?
for U.S. Toy in 2016-2017
• Improve Health
• Corporate Yoga • Maintain Health
• Basketball Net • Learn More About Health Risks
• Wellness Fair • Take Advantage of the Program’s Convenience to
• Biometric Screenings
• Flu Shots Work
• Health Seminars • Win Incentive Prizes
• Health Promotion Campaigns
• Company-Wide Health Challenges & • Reduce Premiums

Contests

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Important Benefit Contacts

BENEFIT PROVIDER PHONE WEBSITE
Medical Cigna (800) 244-6224 www.cigna.com

Dental Cigna (800) 244-6224 www.cigna.com
Vision Cigna (800) 244-6224 www.cigna.com
Health Savings Account UMB (866) 520-4472 www.umb.com
Life, AD&D and LTD Unum www.unum.com
401(k) Plan Fidelity Investments (866) 679-3054 www.401k.com
Human Resources U.S. Toy Company (800) 343-3548 [email protected]
Broker: Mj Insurance, Inc. MJ Insurance, Inc. Email: [email protected]
Lindsey Drew
Terri Jackson
(602) 772-3328

Steps to Locate an In-Network Provider

Medical Dental Vision

Cigna Cigna Cigna
www.cigna.com www.cigna.com
1. Under “Individual & Family www.cigna.com 1. Under “Individual & Family

Plans, Select “Find a Doctor” 1. Under “individual & Family Plans, Select “Find a Doctor”
2. Enter in Search Criteria Plans, Select “Find a Doctor” 2. Enter in Search Criteria
3. Select your plan 3. Select your plan
4. Select Search 2. Enter in Search Criteria 4. Select Search

3. Select Plan

4. Select Dentist on the tabs
above

5. Select Search

The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided
by the employer. The text contained in this Guide was taken from various summary plan descriptions and benefit
information. While every effort was taken to accurately report your benefits, discrepancies or errors are always
possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will
prevail. All information is confidential pursuant to the Health Insurance Portability and Accountability Act of 1996.

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