Stryker Benefits Summary

Transcription

Stryker Benefits SummaryStryker is pleased to provide you with this summary plan description(“SPD” or “Benefits Summary”) describing the healthcare, welfare andretirement benefits available to eligible Stryker employees as ofJanuary 1, 2022.When the unexpected occurs—a serious illness, a long absence from work,even death—we count on Stryker-sponsored healthcare and welfarebenefits for financial protection. In addition, Stryker Corporation sponsorsthe Stryker Corporation 401(k) Savings and Retirement Plan so that youand other employees of Stryker and its participating subsidiaries (allreferred to in this Summary as the “Company”) may save for retirement ona “before-tax” basis. The benefits provided under the 401(k) Plan are inaddition to Social Security.To get the maximum value from your benefit plans, you need tounderstand how they work: what’s covered, what’s not, who is eligible andwhen. This Stryker Benefits Summary provides information about the planprovisions and guidelines governing your healthcare, welfare andretirement benefits.For MoreInformationAdministrative detailsand procedures forStryker’s healthcareand welfare plans canbe found in the YourRights ion about the401(k) Savings andRetirement Plan isincluded within the401(k) RetirementPlan section.) SeeContacts for phonenumbers and webaddresses you can usefor answers to yourquestions.If you have questionsabout the informationThe information presented in the Benefits Summary makes it easy toin this Benefitsunderstand your benefits. Consider this handbook, which is available inSummary, you canprint and online at https://totalrewards.stryker.com/spd, your firstalso contact yourBenefitsresource whenever you have a question about what is covered, how to filerepresentative.claims or your rights as a plan participant. The benefits described aresummaries of the official plan documents and contracts, which govern theplans. They are written in plain language to help you understand how the plans work.When you have questions that are not answered here, please refer to the section calledContacts. The information provided in the Contacts section includes toll-free phone numbersand web site addresses for Stryker’s claims administrators and insurance carriers. Pleasecontact the claim administrators or insurance carriers first when you have questions aboutcoverage or claim status. As always, your Benefits representative is also available to assist youwith complex questions or situations that require special handling.Stryker Benefits Summary - Effective 1/1/22i

Stryker Benefits SummaryTable of ContentsStryker Benefits Summary . iAbout this Summary . 1Healthcare Benefits . 3Participating in Healthcare Benefits. 5Eligibility. 5Ongoing Eligibility . 6Dependents. 6Enrollment . 8Making Changes . 9HIPAA Special Enrollment Rights . 10Life Event Guide—Healthcare.12Your Cost for Healthcare Benefits .15Tobacco Surcharge .15Non-Grandfathered Status . 16When Coverage Begins . 16When Coverage Ends. 16COBRA: Continuing Healthcare Coverage17Continuing Healthcare Coverage uponMilitary Leave . 20If You Have Other Coverage .21Medical Benefits . 22Dental Benefits . 26Other Important Information . 26Bundled Payments . 26Medical Benefits . 27Stryker's Medical Options . 27How the UnitedHealthcare Plans Work. 28Your Choices for Receiving Care . 28Participating Providers . 29UnitedHealth Premium Program . 29Eligible Expenses . 30Your Deductible . 34Your Share in the Cost of Covered Services34Your Out-of-Pocket Maximum . 35Your Medical Benefits . 36Benefit Maximums . 38Emergency Room Care . 38Special Services and Procedures . 38UHC Health Advantage Program . 38Prior Authorization Requirements forthe UnitedHealthcare Plans . 39Second Surgical Opinions . 41Clinical Programs and Resources. 42Consumer Solutions and Self-ServiceTools . 42Condition Management Services . 43Covered Medical Expenses . 46Maternity Benefits . 56Benefits for Outpatient RehabilitationServices . 57Preventive Care Benefits . 58Cellular and Gene Therapy . 59Diabetes Services. 59Enteral Nutrition . 60iiHome Healthcare . 60Skilled Nursing Facility/ InpatientRehabilitation Facility Services . 60Mental Health, Substance-Related andAddictive Disorder and NeurobiologicalDisorder Services . 61Organ Transplant Benefits . 62Ambulance Services . 63Durable Medical Equipment (DME). 64Gender Dysphoria . 65Hearing Aids. 66Hyperhidrosis Treatment. 66Fertility Services and Fertility Solutions(FS) Program . 66Lab, X-ray and Diagnostic - Outpatient68Nutritional Counseling. 68Obesity Surgery . 69Prosthetic Devices . 69Specialty Pharmacy . 69Urinary Catheters . 70Virtual Care Services . 70Expenses Not Covered . 71How to Obtain Medical Benefits . 76How to Reach UnitedHealthcare . 76Medical Plan Definitions . 76Prescription Drug Benefits . 87How Prescription Drug Benefits Work . 87How Prescription Drug CoverageWorks with the PPO Plans . 87How Prescription Drug CoverageWorks with the Basic and PremiumHSA Plans . 88Expenses Covered at 100% under AllUHC Plans . 89Covered Expenses for All UHC Plans 89Expenses Not Covered under All UHCPlans. 90How to Obtain Prescription Drug Benefits91Medical and Rx Claims Procedures . 95Medical and Rx Benefits . 95Required Information . 95Payment of Benefits . 96Submitting Medical or Rx Benefit Claims96Initial Claim Determinations . 97If You Receive an Adverse BenefitDetermination . 99Review of an Adverse BenefitDetermination: What to Do First . 99How to Appeal a Claim Decision . 99Appeal Process . 101Vision Benefits . 105How Vision Benefits Work . 105When You Use Participating EyeMedProviders . 105If You Use Non-Participating Providers106Stryker Benefits Summary - Effective 1/1/22

Stryker Benefits SummaryBenefit Frequency . 107Expenses Not Covered . 107How to Obtain Vision Benefits . 107Time Frames for Processing Out-ofNetwork Claims . 108Time Frames for Responding to AppealedClaims . 108Member Grievance Procedure. 108How to Reach EyeMed . 108Dental Benefits . 109How Dental Benefits Work . 109Schedule of Benefits . 110Covered Dental Expenses. 110Expenses Not Covered . 112How to Obtain Dental Benefits . 112How Payment Is Made . 113Claims Determinations . 113How to Reach Delta Dental . 115Dental Plan Definitions . 115Location-Based Provisions. 117Alabama . 117Healthcare Benefits . 117Eligibility . 117Ongoing Eligibility . 118Other Information . 120California . 121Healthcare Benefits . 121Eligibility . 121Ongoing Eligibility . 122Other Information . 124Hawaii .125Healthcare Benefits .125Eligibility .125Ongoing Eligibility . 126Other Information . 129Cary, Illinois Health Center. 129Medical Benefits Abroad . 129International Plan . 130Healthcare Benefits . 131Other Information . 133Flexible Spending Accounts .135How FSAs Work .135Enrolling in an FSA . 136Life Event Guide – FSA . 137The Importance of Estimating Carefully139When FSA Participation Ends . 140Healthcare Flexible Spending Account(HCFSA). 140How Much You Can Contribute . 140Eligible Expenses . 140Expenses Not Covered . 141Failure to Cash Reimbursement Checks142Qualified Reservist Distribution . 142HCFSA Claim Procedures . 142Day Care (Child and Adult) FlexibleSpending Account (DCFSA) . 146How Much You Can Contribute . 146Stryker Benefits Summary - Effective 1/1/22Eligible Expenses . 146Expenses Not Covered .147Failure to Cash Reimbursement Checks147The Federal Tax Credit . 148How to Obtain DCFSA Benefits . 148Health Savings Account . 153Eligibility .154Enrolling in an HSA .154When Contributions Begin .154When HSA Contributions Stop . 155How HSAs Work . 155HSA Contributions . 155Eligible Expenses .156HSA Withdrawals .159Investment Options. 160Additional Information about the HSA160Life and AD&D Insurance Coverage . 161Coverage at a Glance . 162Disability Coverage . 163Coverage at a Glance . 164401(k) Retirement Plan . 165401(k) Plan (Non-Sales Rep Employees) . 167Overview of the Plan .167Your Accounts .167Your Benefits .167Tax Deferral .167Contacting Vanguard .167Eligibility. 168Contributions to the Plan . 168Company Discretionary Contributions168Pay Deferral Contributions and RothPay Deferral Contributions . 169Catch-Up Contributions . 170Company Matching Contributions . 170Compensation . 171Rollovers . 172Vesting . 172Vested Interest in Your Accounts . 172Forfeitures . 173Vesting Rules Upon Reemployment . 173Vesting Breaks in Service . 173Plan Investments .174Investment of Your Accounts .174Valuation and Adjustment of YourAccounts .174Distributions from the Plan. 175When Benefits Are Distributed . 175Severance from Employment for aReason Other than Death. 175Forms of Distribution of Benefits . 175Distribution of Benefits upon Death . 175Beneficiary .176Income Tax Withholding/DirectRollovers .176Excise Tax on Certain EarlyDistributions . 177Tax Consequences of Roth Distributions177iii

Stryker Benefits SummaryElection to Receive Distribution ofStryker Stock . 177Loans and Withdrawals .178Hardship Loans .178Hardship Withdrawals .179Qualified Reservist Distributions .179Withdrawals After Age 591 2 . 180Rollover Account Withdrawals . 180CARES Act . 180Other Important Plan Information . 180Top-Heavy Status of the Plan . 180Distributions Under QualifiedDomestic Relations Orders . 180Benefits Are Not Insured . 180Claims and Appeals . 180Termination or Amendment of the Plan181Your Rights as a Participant . 181Additional Information . 182Special Provisions Applicable to eTraumaParticipants . 183Special Provision Applicable to PlasmaSolParticipants . 183Special Provision Applicable to PorexSurgical, Inc. Participants . 183Special Provision Applicable to BostonScientific Corporation Participants . 184Special Provision Applicable to GaymarIndustries, Inc. Participants . 184Special Provisions Applicable to DivestedBiotech Participants . 184Acquisitions After September 30, 2012 184CARES Act Addendum . 184Eligibility . 184Coronavirus Related Distributions(CRD) . 184Loans . 185Required Minimum Distribution Relief185401(k) Plan (Sales Reps) .187Overview of the Plan .187Your Accounts .187Your Benefits .187Tax Deferral .187Contacting Vanguard .187Eligibility. 188Contributions to the Plan . 188Pay Deferral Contributions and RothPay Deferral Contributions . 188Catch-Up Contributions . 190Company Matching Contributions . 190Compensation . 191Rollovers . 191Vesting . 192Vested Interest in Your Accounts . 192Forfeitures . 192Vesting Rules Upon Reemployment 192Vesting Breaks in Service . 193ivPlan Investments . 193Investment of Your Accounts . 193Valuation and Adjustment of YourAccounts . 193Distributions from the Plan. 194When Benefits Are Distributed . 194Severance from Employment for aReason Other than Death. 194Forms of Distribution of Benefits .195Distribution of Benefits upon Death 196Income Tax Withholding/DirectRollovers .197Excise Tax on Certain EarlyDistributions .197Tax Consequences of Roth Distributions198Election to Receive Distribution ofStryker Stock . 198Loans and Withdrawals . 198Hardship Loans . 198Hardship Withdrawals .200Qualified Reservist Distributions .200Withdrawals After Age 591 2 .200Rollover Account Withdrawals . 201CARES Act . 201Other Important Plan Information . 201Top-Heavy Status of the Plan . 201Distributions Under QualifiedDomestic Relations Orders . 201Benefits Are Not Insured . 201Claims and Appeals . 201Termination or Amendment of the Plan202Your Rights as a Participant . 202Additional Information . 203Special Provisions Applicable to eTraumaParticipants . 204Special Provision Applicable to PlasmaSolParticipants . 204Special Provision Applicable to PorexSurgical, Inc. Participants . 204Special Provision Applicable to BostonScientific Corporation Participants . 205Special Provision Applicable to GaymarIndustries, Inc. Participants . 205Special Provisions Applicable to DivestedBiotech Participants . 205Acquisitions After September 30, 2012 205CARES Act Addendum . 205Eligibility . 205Coronavirus Related Distributions(CRD) . 205Loans . 206Required Minimum Distribution Relief206Additional Benefits . 207Adoption Assistance Plan . 207How Adoption Assistance BenefitsWork . 207Stryker Benefits Summary - Effective 1/1/22

Stryker Benefits SummaryExpenses Not Covered .208How to Obtain Adoption AssistanceBenefits .208Employee Assistance Program (LifeWorks)208Strive for Wellbeing Program . 209Your Rights and Responsibilities . 211The Family and Medical Leave Act . 211Qualified Medical Child Support Orders212Patient Protection Notices. 212Time Limits for Claims Filings . 213Subrogation and Reimbursement . 213Assignment of Benefits . 216Payment of Benefits . 216Overpayment and Underpayment ofBenefits . 217Medicare Crossover Program. 217Other Information . 218Your Rights under ERISA. 219Contacts.221Stryker Benefits Summary - Effective 1/1/22v

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Stryker Benefits Summary - Effective 1/1/21 i Stryker Benefits Summary Stryker is pleased to provide you with this summary plan description ("SPD" or "Benefits Summary") describing the healthcare, welfare and