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Published by lindsey.drew, 2019-12-06 14:49:12

Quest Analytics 2020 Benefits Guide

Quest Analytics Benefit Guide-2020

Keywords: Benefits,healthcare,wellness

2020 Benefits Guide

January 1-December 31, 2020


Table of Contents

Open Enrollment—Eligibility .......................................................................3
Medical Benefits ........................................................................................4

Preventive Care Coverage ...............................................................5
Tips for Using your Medical Benefits................................................6
Telehealth ......................................................................................7
Dental Benefits ..........................................................................................8
Vision Benefits ...........................................................................................9
Employee Contributions ........................................................................... 10
Life and Disability Benefits ....................................................................... 11
Flexible Spending Accounts ...................................................................... 12
Qualified Transit & Parking ....................................................................... 13
Employee Resources................................................................................. 14
Annual Notices.................................................................................... 15-16


Benefit Eligibility Information

Benefits Eligibility:

Employees become eligible for benefits the first of the month after date of hire. Medical,
Dental, Vision and Life Insurance/ AD&D coverage is also available for eligible family mem-
bers. Here are the family members who are eligible for coverage:

Family Member Requirements for Coverage

Your Spouse Must be your legal spouse for federal tax purposes
including state recognized common-law spouses and
Your Children including: same gender spouses.
• Biological, adopted and step children Children must be dependents for whom you have
• Disabled children dependent on you for support legal custody and:
• Children for whom you have legal custody or that
• Under age 26 for medical, dental, vision &
you are required to cover under a Qualified voluntary life insurance
Medical Child Support Order (QMCSO)
• A disabled child of any age

Your Domestic Partner Must submit an Affidavit of Domestic Partnership. If
your domestic partner does not meet the IRS defini-
tion of an eligible dependent, portions of the contri-
butions for his/her coverage will be taken after-tax.

Qualified Life Events-Defined:

You may make changes to your medical, dental, vision, life insurance or flexible spending accounts elections
during the 2020 plan year only if you experience a qualified life status change. A qualified life status change
is defined by the IRS as one of the following:

1. A change in legal marital status (marriage, divorce, legal separation). You are not permitted to keep a
former spouse on your coverage. After a divorce a former spouse is no longer an eligible dependent.

2. A change in the number of dependents - birth/adoption, placement of adoption of a child, dependent
becomes eligible or no longer eligible.

3. A change in employment status for you, your spouse or dependent that affects healthcare coverages. (i.e.
if your spouse loses coverage elsewhere)

To declare a Life Status Change, access Paycom to log the event within 31 days of the qualified life status change.


Medical Benefits

Choice Plus Choice Plus Choice Plus Choice Plus
Annual Deductible In-network Out-of-network In-network Out-of-network

Out-of-Pocket Maximum Individual: $750 Individual: $1,500 Individual: $3,500 Individual: $7,000
Family: $1,250 Family: $2,500 Family: $7,000 Family: $14,000
Coinsurance Individual: $3,000 Individual: $10,000
Preventive Care Family: $6,000 Individual: $7,000 Individual: $3,500 Family: $20,000
Outpatient Care Covered 80% Family: $14,000 Family: $7,000
PCP office visits 100%; no deductible Covered 100% Covered 70%
Specialist office visits Covered 60% 100%; no deductible
$20 copay 60% after deductible 100%; no deductible
Outpatient Surgery $40 copay 70% after deductible
60% after deductible 100% after deductible 70% after deductible
Telehealth Connection 80% after deductible 60% after deductible 100% after deductible 70% after deductible
Services $500 deductible per admis- 100% after deductible
Outpatient Lab, X-Ray $20 copay sion then 60% covered 70% after deductible
Advanced Radiology 100% after deductible 70% after deductible
80% after deductible 60% after deductible 100% after deductible
70% after deductible
60% after deductible 100% after deductible
70% after deductible
(MRI, MRA, CAT & Pet 80% after deductible 60% after deductible 100% after deductible
Scan) 70% after deductible
100% after deductible 70% after deductible
Hospital Care 100% after deductible
70% after deductible
Inpatient 80% after deductible $500 deductible per admis- 100% after deductible 70% after deductible
sion then 60% covered 100% after deductible
70% after deductible
Emergency Care $150 copay $150 copay 100% after deductible
Hospital Emergency $50 copay 60% after deductible 70% after deductible
100% after deductible
Room (waive if admitted) 100% after deductible
Urgent Care After Deductible is Met: 100% after deductible
100% after deductible 100% after deductible
Maternity Care 100% after deductible
100% after deductible 100% after deductible
Pre and Post-natal care 80% after deductible 60% after deductible 100% after deductible
100% after deductible 100% after deductible
Hospital services for 80% after deductible 60% after deductible 100% after deductible
mother and child 100% after deductible 4
Mental Health

Inpatient 80% after deductible $500 deductible per admis-
sion then 60% covered

Outpatient $40 copay at physician’s 60% after deductible
office; other locations plan

pays 80%

Retail Drug Program

(30 day supply) $10 copay 50% covered
Generic $30 copay 50% covered
Brand $50 copay 50% covered
Mail Order

(90 day supply) $25 copay 50% covered
Generic $75 copay 50% covered
Brand $125 copay 50% covered

Preventive Care is Covered!

Preventive care can help you avoid potentially serious health conditions and/or obtain
early diagnosis and treatment. Generally, the sooner your doctor can identify and treat a
medical condition, the better the outcome. Under the Affordable Care Act (ACA), you can
get certain preventive health care services, covered at 100 percent, without any cost to
you. Just obtain your preventive care from a health plan network provider. Diagnostic
(non-preventive) services are also covered, but you may have to pay a copayment, coin-
surance or deductible.

All Members: Covered for Individuals with

• Preventive care visits for adults Specific Needs or Risks:

• All routine immunizations recommended by ACIP • Aspirin for men age 45-79 and women age
55-79 FDA-approved female contraception
All member depending on gender & age: methods

• Colorectal cancer screening • Fluoride supplements for children age 0-6
• Cholesterol and lipid disorders screening
• Certain sexually transmitted diseases • Folic acid supplements for women
• Depression screening
• Diabetes screening • Risk-reducing breast cancer medications for
• Hepatitis C screening women, with prior authorization

• Iron supplements for children age 0-1

• High blood pressure screening • Tobacco cessation drugs (may require prior
• Lung cancer screening for those age 55 to 80 authorization)

• Screening and counseling in a primary care setting for: • Vitamin D supplements

 Tobacco use

 Obesity

 Diet and nutrition

 Alcohol abuse

For more information about preventive guidelines for your age and gender,

visit 5

Medical Benefits

If you enroll in one of the UnitedHealthcare medical plans you will receive your permanent cards
in the mail shortly, but temporary cards can be printed within 5 – 7 business days of enrolling:

1. Go to

2. Click the "Register Now" icon (left hand side of the screen)

3. Enter in your First Name and Last Name as it would appear on your Insurance Card

4. Enter your Date of Birth

5. You will then need to enter your Member ID. Your Member ID is your SSN with the
dashes (i.e. XXX-XX-XXXX)

6. Enter in our Group Number, 0919741 then click next. We are on the Choice Plus Plan

7. Set up your online account by entering a unique user name and password. (Note the rules
listed on the website regarding the use of letters, numbers and symbols). Click on the link
at the bottom to complete the registration. This will take you to the home page of your
online account.

8. On the home page of your online account, click on the "Print an ID Card" icon (middle of the
page, right-hand side)

Find care.
• Locate physicians and facilities.
• Learn about procedures and treatments.
• Research available providers.
• Access hospital quality and safety data.
• Review price and quality for more than 875 medical
services for almost 600 health conditions.
• Compare care and prescription costs


Virtual Visits

When you’re sick and need care quick, a Virtual Visit is a convenient way to start
feeling better faster.
With a Virtual Visit, you can see and talk to a doctor via mobile device or computer 24/7, no
appointment needed. The doctor can give you a diagnosis and prescription, if needed. And
with a UnitedHealthcare plan, your cost is $20 on the PPO Plan.

To get started with a Virtual Visit, go to

Conditions treated by Virtual Visit doctors:

• Acne • Sinus infections
• Allergies • Skin infections
• Asthma • Sore throat
• Bronchitis • Urinary tract infections
• Cold and Flu • Insect bites
• Diarrhea • Joint aches
• Earaches • Nausea
• Fever • Pinkeye
• Headache • Rashes

Prepare for your Visit:

Have these three items ready to register and
complete your Virtual Visit:

• Health plan ID card

• Credit card
• Pharmacy location


Dental Benefits

Dental PPO Plan In-Network Cigna
Negotiated Fee
Claims Paying Percentile Out-of-Network
Deductible $50/$150 90th Percentile UCR
Waived for Preventive Yes
Preventive Coverage 100% $50/$150
Basic Coverage 90%
Major Coverage 60% Yes
Calendar Year Max 100%
Orthodontia (Child Only) $2,000 80%
Lifetime Max-Orthodontia 50% 50%

$1,500 $1,500


Visit to
search for an in network dentist today!


Vision Benefits

Healthy Rewards®

Vision Network Savings Program:

When you see a Cigna Vision Network Eye
Care Professional, you can save 20% (or
more) on additional frames and/or lenses,
including lens options, with a valid
prescription. This savings does not apply to
contact lens materials. See your Cigna
Vision Network Eye Care Professional for

Vision PPO Plan Cigna – VSP Network

Exam Copay In-Network Out-of-Network
Materials Copay
Eye Exam $10 N/A
Single Vision Lenses
Bifocal $25 N/A
Lenticular Covered in full after copay $39 Allowance
Frequency of Services:
Covered in full after copay $23 Allowance
Lenses Covered in full after copay $37 Allowance
Contact Lenses (in lieu of frames/lenses) Covered in full after copay $49 Allowance
Contact Lenses – Elective Covered in full after copay $64 Allowance
Contact Lenses – Medically Necessary
Once Per Calendar Year

Once Per Calendar Year

Once Per Calendar Year

Once Per Calendar Year

$130 + 20% Off Balance $46 Allowance
$130 Allowance $100 Allowance
$210 Allowance
Covered in full after copay

Finding a Doctor

There are three ways to find a quality eye doctor in your area:

1. Log into,”Coverage”, select Vision page. Click on Visit Cigna Vision. Then select “Find a Cigna
Vision Network Eye Care Professional” to search the Cigna Vision Directory.

2. Don’t have access to Go to, top of the page select “Find A Doctor, Dentist or Facility”,
click Cigna Vision Directory, under Additional Directories.

3. Prefer the phone? Call the toll-free number found on your Cigna insurance card and talk with a Cigna Vision cus-
tomer service representative.


Bi-Weekly Contributions


Employee $ Employee $
Employee Only
Employee + Spouse $39.62 $0
Employee + Child(ren) $153.67 $99.04
Family $118.91 $76.98
$278.09 $165.31

Dental & Vision

Tier Dental Vision
Employee $ Employee $
Employee Only
Employee + Spouse $0 $0
Employee + Child(ren) $14.26 $3.06
Family $20.33 $3.09
$29.73 $4.94


Life & Disability Benefits

Term Life & AD&D Benefits All Full-Time Employees
Who is Eligible? 1 x’s salary up to $100,000
Term Life insurance is an employer sponsored benefit Benefit Amount 35% at age 65; 50% at age
giving all covered employees a basic life coverage Reduction Schedule Employment Ends
during their employment. Duration

Benefits All Full-Time Employees Supplemental Life & AD&D
Who is Eligible?
Employees are able to purchase additional Life &
Employee Benefit $10,000 increments to AD&D insurance for themselves, spouse or children.
Amount $300,000 Rates are based on age. This additional coverage is
paid for by the employee and is contributed to on a
$5,000 increments to pre-tax basis out of your paycheck. Should you elect
Spouse Benefit Amount this benefit outside of the open enrollment window, or
beyond the guarantee issue amount you may be
$100,000 required to provide additional health information.

$100,000 for employees,
Proof of Good Health at

$30,000 for spouses

Short-Term Disability Benefits All Full-Time Employees
Who is Eligible?
Short-Term Disability is an employer sponsored benefit
that provides income protection for employees who have Benefit Amount 60% of weekly pre-disability
a “Short-Term” disability resulting from a covered injury or earnings up to $2,308
sickness. Benefits begin at the end of the elimination
period and continue while you are disabled up to the Elimination Period for 7 Days (Payments begin on the
maximum benefit duration.
Injury or Illness 8th day)

Maximum Duration 25 Weeks

Benefits All Full-Time Employees Long-Term Disability
Who is Eligible? 60% of monthly pre-disability
Long-Term Disability earnings to $10,000 Long-Term Disability is an employer sponsored
Benefit (Monthly) 180 days benefit that provides income protection insurance to
Elimination Period employees for “Long-Term” disabilities resulting from
a covered injury or sickness. Benefits begin at the
Maximum Duration SSNRA end of the elimination period and continue while you
are disabled up to the maximum benefit duration.


Flexible & Health Spending Accounts

Flexible Spending Accounts (FSAs) are designed to save you money on your taxes. They work

similar to a savings account. Each pay period, funds are deducted from your pay on a pretax basis and are
deposited to your Health Care and/or Dependent Care FSA. You then use your funds to pay for eligible health
care or dependent care expenses.

Plan Features Health Care FSA Dependent Care FSA
Eligible Expenses
• Medical Plan Deductibles • Child/ Adult care
Annual Contribution Limits • Prescription Drugs • In-home dependent care
• Vision Exams/Glasses/Contacts • Nursery school
• Laser Eye Surgery • Before & after school care
• Day Camp
Maximum contribution is $2,750 for the
2020 plan year Maximum contribution is $5,000 for the 2020
plan year

Claims Deadlines & Guidelines Qualifying healthcare related expenses Qualifying dependent care expenses must be:
(Any unused funds will be
forfeited, this is a use it or lose it must be: • Incurred between Jan 1, 2020 and
type account.)
• Incurred between Jan 1, 2020 – December 31, 2020

March 15, 2020 • Final date to submit reimbursement requests

• Final date to submit reimbursement is March 31, 2020

requests is March 31, 2020 • Incurred by you

• Incurred by you or by anyone you claim • Necessary so you can work

as a dependent on your tax return • If you are married, necessary so your spouse

• Medically necessary can work or attend school full-time or neces-

• Not reimbursable under any other plan sary to care for your mentally or physically

• Tax deductible under IRS rules disabled spouse

• Not related to cosmetic procedures

Health Savings Accounts (HSAs) are savings accounts used in conjunction with a high-deductible

health plan that allows users to save money tax-free against medical expenses. Contributions are made
pre-tax from your paycheck. 2020 annual maximum contribution limits cannot exceed:
• $3,550/year for individual (up from $3,500 in 2019)
• $7,100/year for family (up from $7,000 in 2019)
• $1,000/year “catch up” if you are 55 years of age or older, but not entitled to Medicare benefits

Quest Analytics will MATCH employee’s H.S.A contributions:
• Employee Only: $20 monthly
• All other Tiers: $40 monthly

Your H.S.A is owned by YOU. To be eligible for a HSA you must:

• Funds roll over from year-to-year, allowing • Be covered by a HDHP
you to save for future medical expenses or • Not be covered by other non-HDHP health plans
potential retirement savings • Not be enrolled in Medicare
• Not be claimed as dependent on someone’s tax return
• Funds are yours if you leave the employer, • Not be contributing to a general FSA
move to another medical carrier, or retire


Commuter Benefits

Pre-tax benefit account used to pay for:

• Qualified parking as part of your daily commute to work
• Public transit as part of your daily commute to work

A great way to:

• Put extra money in your pocket each month
• Make your commute more convenient

Commuter Benefit Limit

Pre-Tax Commuter Up to $270 monthly

Pre-Tax Parking Up to $270 monthly


If you enroll for payroll contributions through Benefits Enrollment
in Paycom, Primepay will send you a debit card and program
information. No enrollment form is necessary.


Benefit Questions?

Your one-stop Benefit Concierge Service team is here to assist you with

all your benefits issues, questions and concerns.

* Questions regarding billing * Claim issues

* ID card issues * Provider network questions

* Benefits questions * Prescription issues

Contact Francesca at [email protected] or (914) 798-1063
Monday - Friday, 9:00am - 5:00pm (EST)

Contact HR at [email protected] or (816) 601-1112

Carrier Questions?

Benefit Phone Number Wesite Group Number
Medical 866-414-1959 0919741

Dental 800-244-6224

Vision 800-244-6224

Life & Disability 800-423-2765

HSA/FSA/Commuter N/A


Annual Notices

NEWBORNS' AND reconstructive surgery in a reasonable period of time,
MOTHERS' HEALTH manner determined in whether a medical child
PROTECTION ACT OF 1996 consultation with the attending support order is qualified, and
(NEWBORN'S ACT) physician and the patient. to administer benefits in
Group health plans and health Coverage includes accordance with the applicable
insurance issuers generally reconstruction of the breast on terms of each order that is
may not, under federal law, which the mastectomy was qualified. In the event you are
restrict benefits for any performed, surgery and served with a notice to provide
hospital length of stay in reconstruction of the other medical coverage for a
connection with childbirth for breast to produce a dependent child as the result
the mother or newborn child symmetrical appearance, and of a legal determination, you
to less than 48 hours following prostheses and treatment of may obtain information from
a vaginal delivery, or less than physical complications at all your employer on the rules for
96 hours following a cesarean stages of the mastectomy, seeking to enact such
section. However, federal law including lymph edemas. Call coverage. These rules are
generally does not prohibit the your Plan Administrator for provided at no cost to you and
mother's or newborn's more information. may be requested from your
attending provider, after employer at any time.
consulting with the mother, QUALIFIED MEDICAL CHILD
from discharging the mother SUPPORT ORDER (QMCSO) NOTICE OF PRIVACY
or her newborn earlier than 48 QMCSO is a medical child PRACTICES (HIPAA)
hours (or 96 hours as support order issued under In compliance with the Health
applicable). State law that creates or Insurance Portability and
recognizes the existence of an Accountability Act of 1996
In any case, plans and issuers “alternate recipient's” right to (HIPAA), your employer
may not, under federal law, receive benefits for which a recognizes your right to
require that a provider obtain participant or beneficiary is privacy in matters related to
authorization from the plan or eligible under a group health the disclosure of health-related
the issuer for prescribing a plan. An “alternate recipient” is information. The Notice of
length of stay not in excess of any child of a participant Privacy Practices (provided to
48 hours (or 96 hours). (including a child adopted by you upon your enrollment in
or placed for adoption with a the health plan) details the
THE WOMEN’S HEALTH AND participant in a group health steps your employer has taken
CANCER RIGHTS ACT OF plan) who is recognized under to assure your privacy is
1998(WHCRA, ALSO KNOWN a medical child support order protected. The Notice also
AS JANET’S LAW) as having a right to enrollment explains your rights under
Under WHCRA, group health under a group health plan with HIPAA. A copy of this Notice is
plans, insurance companies respect to such participant. available to you at any time,
and health maintenance Upon receipt, the administrator free of charge, by request
organizations (HMOs) offering of a group health plan is through your employer.
mastectomy coverage must required to determine, within a
also provide coverage for


Annual Notices

COVERAGE EXTENSION RIGHTS (Children’s Health Insurance curity Act, the Internal Revenue

UNDER THE UNIFORMED SER- Program). Code and the Public Health Ser-

VICES EMPLOYMENT AND • You must request special en- vices Act by imposing new man-
REEMPLOYMENT RIGHTS ACT rollment within 60 days of the dates on group health plans that
(USERRA) loss of coverage and/or within provide both medical and surgi-

If you leave your job to perform 60 days of when eligibility is cal benefits and mental health or
military service, you have the determined for the premium. substance abuse disorder bene-
right to elect to continue your
fits. Among the new require-

existing employer-based health MICHELLE’S LAW ments, such plans (or the health
plan coverage for you and your Michelle’s Law permits seriously insurance coverage offered in
dependents (including spouse) ill or injured college students to connection with such plans) must
for up to 24 months while in the continue coverage under a group ensure that the financial require-
military. Even if you do not elect health plan when they must leave ments applicable to mental
to continue coverage during your school on a full-time basis due to health or substance abuse disor-
military service, you have the their injury or illness and would der benefits are no more restric-
right to be reinstated in your em- otherwise lose coverage. The tive than the predominant finan-
ployer’s health plan when you are continuation of coverage applies cial requirements applied to sub-
reemployed, generally without to a dependent child’s leave of stantially all medical and surgical
any waiting periods or exclusions absence from (or other change in benefits covered by the plan (or
for pre-existing conditions except enrollment) a postsecondary ed- coverage), and there are no sepa-
for service-connected injuries or ucational institution (college or rate cost sharing requirements
illnesses. university) because of a serious that are applicable only with re-
illness or injury, while covered spect to mental health or sub-
COVERAGE EXTENSION RIGHTS under a health plan. This would stance abuse disorder benefits.
SPECIAL ENROLLMENT RIGHTS otherwise cause the child to lose
Effective April 1, 2009 you and GINA broadly prohibits covered
your dependents who are eligible Coverage will be continued until: employers from discriminating
for coverage, but who have not against an employee, individual,
enrolled, have the right to elect 1. One year from the start of the or member because of the em-
coverage during the plan year medically necessary leave of ployee’s “genetic information,”
absence, or

under two circumstances: 2. The date on which the cover- which is broadly defined in GINA

• You or your dependent’s state age would otherwise terminate to mean (1) genetic tests of the
Medicaid or CHIP (Children’s under the terms of the health individual, (2) genetic tests of
Health Insurance Program) plan; whichever is earlier.
family members of the individual,

coverage terminated because and (3) the manifestation of a

you ceased to be eligible. MENTAL HEALTH PARITY AND disease or disorder in family

• You become eligible for a CHIP ADDICTION EQUITY ACT OF members of such individual.
premium assistant subsidy un- 2008

der state Medicaid or CHIP This act expands the mental

health parity requirements in the

Employee Retirement Income Se-


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