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Your TotalCompensationStatementSetting Us ApartFrom The Competition
Contact Information:Benefit Plan Enrollment:www. Smartben.comEmployee tmHub\Human ResourcesHub\WellnessHealth Insurance:Community Blue PPO, Traditional, DenteMax and VSPEmail: EmployeeInquiry@bcbsm.comNote: Be sure to include your contract number (off ofyour insurance card) as well as your group number in allcommunications.BCNOmbudsman’s Office: 1-888-265-4703Web essMail Code X-310600 Lafayette EastDept. 1703Detroit, MI 48226Accident Fund Group #:38110Prescription Refill Center:1-800-651-0155Medco Member Services:1-800-903-8346Dental Services:1-877-258-0167Other Helpful Numbers:BCBSM Mail Code: B-183Emergency/Weather hotline: 1-888-WORK4AFRITE Call: 1-800-852-8757ADP Cobra Services: 1-800-526-2720BCBSM Retirement Administration:retirementadministration@bcbsm.com or 1-800- 922-0699 or(313) 225-9609Employee Assistance Program:EAP Consultants - 1-800-869-0276 or www.eapconsultants.comFidelity Investments: 1-800-378-4015 or www.401k.comFlexible Spending Accounts:1-800-654-6695 or www.flexdirect.adp.comGroup Universal Life Insurance Company:Marsh@WorkSolutions - 1-800-621-2358Group Life Insurance Company: Reliastar - 1-800-955-7736IncentaHealth: http://accidentfund.incentahealth.comLong-Term Disability: 1-800-707-2288Service Awards:OC Tanner 1-800-453-7490 -Term Disability/Integrated Disability Management:Lana McDowell, R.N. – (517) 367-6370 orlanam@accidentfund.com
your total compensation statement2010Your Total Compensation2010 Benefit PlansJanuary 2009 – December 2009Accident FundContributionCategoryDirect PayRegular PayAnnual/School LeaveSick LeavePersonal LeaveHoliday LeaveOvertimeIncentive PayOther Pay 1Total Direct PayRequired BenefitsSocial Security TaxesMedicareUnemploymentWorkers’ CompensationHealth BenefitsMedical and PrescriptionDentalVisionEmployee Assistance ProgramLife and Disability BenefitsBasic Life and AD&DLong-Term DisabilityRetirement Benefits401(k) PlanPension Plan 2Health Promotion BenefitsFund AdvantageHealth Promotion/Wellness 3Additional BenefitsParkingYour Total CompensationYourContribution 35,029.71 3,279.30 1,413.03 308.64 1,697.52 29.16 773.98 3,000.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 45,531.34 0.00 2,871.67 671.60 344.00 136.42 2,871.67 671.60 0.00 0.00 13,088.64 1,407.24 261.84 26.04 0.00 0.00 0.00 0.00 278.40 228.43 0.00 100.36 517.78 3,517.38 1,035.52 0.00 750.00 115.00 0.00 0.00 1,344.00 0.00 71,089.78Other Pay includes one or more of the following pay categories: Bereavement, Birthday, Court, Jury, Mileage, Military,On Call, Relocation, SRA, STD, and Vehicle Stipend.The pension plan amount represents the average employer cost of pension benefits for 2009 applied to your base pay.3 The Wellness program amount Includes average cost per employee for all e-Balance programming and incentives.2A Picture is Worth a Thousand WordsThis chart illustrates your total compensation package63%23%DIRECT PAYRETIREMENT & OTHERHealth Care PlansMedical and Prescription InsuranceAccident Fund offers a choice of three medical plans: Community Blue PPO, BlueCare Network HMO and Healthy Blue Living HMO. Our records show you haveEE Family coverage in the following medical plan.Community Blue PPOYour In-Network CostDeductiblePreventive Care ServicesOffice Visits & Urgent CareEmergency RoomInpatient Hospital CarePrescription Retail (30 days)Prescription Mail Order (90 days) 250 per member, 500 per familyCovered at 100% - one per calendar year 10 copay 50 copay for facility; 100% for ER professional feesCovered at 100% after deductibleCopay: 7 generic, 15 formulary, 30 non-formularyCopay: 14 generic, 30 formulary, 60 non-formularyDental InsuranceAccident Fund offers a choice of two Dental plans: Exclusive Dental Plan andTraditional Plus Plan. Our records show you have EE Family coverage in thefollowing dental plan.Traditional Plus PlanYour CostPreventive ServicesDiagnostic ServicesRestorative Services & Adjunctive ProceduresOral Surgery, Periodontics & EndodonticsProsthondonticsOrthodontic ServicesAnnual Maximum (calendar year)Covered at 100%Covered at 100%Covered at 75%Covered at 75%Covered at 50%Covered at 50%; lifetime max of 2,400 2,300 per memberVision InsuranceAccident Fund offers the Blue Vision (VSP) and the Blue Traditional vision plans.Our records show you have EE Family coverage in the following vision plan.VSP VisionEye ExamEyeglassesContact Lenses(medically necessary)In-Network 5 copay 7.50 copay, maximum 150 7.50 copayHEALTH, LIFE & DISABILITYREQUIREDEmployees may pay for health and/or dependent care expenses with pre-taxdollars, which will be payroll deducted for your convenience. The annualmaximum for each account is 5,000.Health Care Flex Spending AccountYou have not elected to contribute to the Health Care Flex Spending Account.Dependent Day Care Flex Spending AccountOut-of-Network ProviderReimbursed up to 35 less 5 copay 7.50 copay, up to predetermined amtReimbursed up to 210 after 7.50 copayPremium Only Plan (POP)6%8%The following information reflects your 2010 benefit elections including highlights ofthe plans in which you are enrolled. For more information about a specific benefitplan, please refer to the benefit descriptions on the Human Resources website.Questions about your individual coverage may be directed to Human Resources orthe appropriate insurance carrier. All contact information is listed on the inside frontcover of this statement. 4,679.15Note: The information above is based on data as of 12/31/2009 and may not reflect mid-year changes to plantype or contributions.1Flexible Spending Accounts (FSAs)POP allows employees to deduct medical insurance premiums for their paycheck pretax. Cost savings are achieved because Social Security and federal and state incometaxes are not applied to the premium deductions.You have elected to contribute 2,500 annually to the Dependent Care FlexSpending Account.Life and Disability BenefitsLife and AD&D InsuranceAccident Fund provides basic life insurance equal to two times your annual basesalary and also occupational accidental death and dismemberment (AD&D)insurance. Accident Fund pays 100% of the cost of this benefit. Our recordsshow you have 80,000.00 of basic life and 100,000.00 AD&D coverage.Group Travel Accident PlanGroup Travel Accident insurance is provided by Blue Cross Blue Shield ofMichigan. This plan provides coverage for you in the event you die or lose a hand,foot and/or eyesight as a result of an accident while traveling on company businessas an employee of Accident Fund.Short-Term Disability (STD)Short-term disability works in conjunction with Accident Fund's leave programs.After fifteen consecutive days of a qualifying disability, short-term disability benefitstake effect, paying 66 2/3% of base salary for up to 90 days.Long-Term Disability (LTD)Accident Fund offers a company-paid LTD plan that provides a benefit equal to66 2/3% of your gross income after 90 days of disability. All insurance premiums,including medical and dental, will also continue to be paid for the first threemonths on LTD.
your total compensation statement2010Retirement BenefitsHealth Promotion BenefitsLong-term planning is a critical part of your financial security. Accident Fund offers tworetirement plans (in addition to Social Security benefits) to help you achieve financialsecurity in your retirement years.eBalancePresenting Your 2009Total Compensation StatementOur enterprise wide eBalance program provides comprehensive wellness and healthpromotion programs that address all areas of health.To: Harry Hardworker401(k) Savings PlanEmployee Assistance Program (EAP)Employees are eligible to participate in the company’s 401(k) plan through FidelityInvestments after completing three months of service. Contributions are allowedbetween 1% and 96.5% (in half percent increments) of your bi-weekly basecompensation on a pre-tax basis. Employees who are 50 years of age or older arealso eligible to make catchup contributions. After one year of service, Accident Fundwill make contributions equal to 50% of the amount contributed, up to 10% of yourbase bi-weekly compensation. The maximum the company matches is 5%. Allcontributions are subject to IRS limits. In 2010 the maximum electives deferred is 16,500 and the maximum catchup contribution for those age 50 and older is 5,500.Your employee contribution as of January 1, 2010, is 6.0%.Accident Fund’s EAP provider is EAP Consultants. They offer assessment, shortterm counseling, and referral services for a wide range of personal problems, as wellas a variety of work/life issues. This benefit is 100% paid by Accident Fund.Pension - Retirement Income PlanAccident Fund provides a fully company paid retirement account plan. All representedemployees over 21 years of age, hired prior to January 1, 2010, with one year ofservice begin earning service credits as of their hire date. Vesting ocurs after five yearsof credited service or at age 65 regardless of number of years of service. In 2010, themultiplier for the minimum benefit factor is 38 per month. To learn more about yourindividual benefits under this plan, go to https://bcbsmi.pensionpath.com.Fund AdvantageThis cafeteria-style, miscellaneous benefit plan reimburses employees for eligibleexpenses. Fund Advantage offers employees up to 500 annually after one year ofservice, 750 after ten years of service, or 1,000 after 20 years of service arecompleted. Reimbursements are issued with payroll checks and are taxable income.Eligible expenses include: Fitness membership & equipment Computer Packages Weight loss programs Dependent Care Supplemental Health Insurance Additional Employee Tuition Supplemental Life Insurance Dependent TuitionAdditional BenefitsSocial SecurityL-HOPEBoth you and Accident Fund contribute a percentage of your earnings to SocialSecurity. For more information call 1.800.772.1213 or visit www.ssa.gov.L-HOPE is designed to encourage Lansing area employees to buy a home in thecommunity where they work. This program annually provides up to five eligibleemployees with a loan to be used for costs associated with purchasing either a homeor rental property in Lansing. L-HOPE loans are offered on a first-come first-servedbasis to employees who do not currently own a home in the Lansing city limits.Paid Time OffAnnual LeavePaid ParkingAnnual leave is be used to cover absences for vacation and necessary personalbusiness. The number of annual leave hours you accrue per 80 hours of paidservice depends on your total service credit. Annual leave accumulation is cappedbased on years of service.Employees who work in the Lansing offices receive 100% company paid parking.Sick LeaveSick leave may be used to cover medical appointments, illness, injury or disability.You earn four hours of sick leave each bi-weekly pay period in which eighty hours ofservice is completed.Holiday LeaveYou receive 11 holidays each year: New Year’s Day, Martin Luther King Day, GoodFriday, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Day afterThanksgiving, Christmas Eve, Christmas and a Christmas Floating Day. Additionally,in years when Independence Day falls on a Tuesday or Thursday, the Mondaybefore or the Friday after the holiday is also granted as a paid holiday.RITE CallHigh standards are more than a slogan or catch phrase, they are a way of doingbusiness. Maintaining high standards of Respect, Integrity, Truth and Ethics are keycomponents when building a reputation for trust and excellence. Accident Fund’sRITE Call program offers a hotline at 1-877-852-8757, which is available 24 hours aday / 7 days a week when all other internal avenues have been explored.Tuition AssistanceAccident Fund offers a generous tuition assistance program as a benefit to help ouremployees attain their educational goals. This benefit covers 100% of all qualifyingtuition, tests, fees, books and other required expenses up to an annual tuition limit.For an undergraduate degree, the limit is 5,000 annually. For employees pursuing agraduate level degree, the limit is 5,500 annually (up to 5,250 is available tax-free).Birthday HolidayEmployees with 15 or more years of service are eligible to receive their birthday offwith pay.Additional LeaveEmployees are also entitled to paid time off for Bereavement Leave, Jury Duty, andMilitary Leave.Harry Hardworker - 100-630We are pleased to present you with your personal 2009 Total CompensationStatement. It is designed to help you understand the full value of your annualcompensation and benefits.Pay is an important part of our compensation strategy, but it is only one part.Your total compensation package includes your base salary, annual incentiveaward, health and welfare benefits, retirement benefits, healthpromotion/wellness benefits and other benefits.As you review the value of your 2009 total compensation package, you will alsofind information about the 2010 benefit plans in which you participate, as wellas optional coverage that is available to you.Please review your Total Compensation statement carefully and keep it forreference, just as you keep your other important documents. If you should haveany questions about your statement, please call your Human Resources office.We appreciate all you do to contribute to the success of the company. Thankyou for helping to make Accident Fund and United Heartland great places towork!Sincerely,Darcy Kerr,Vice President, Human Resources
Other Benefits:AFLAC (Accident Fund Only)Alternative Work SchedulesCommunity InvolvementLife Secure Long Term Care Insurance (Accident Fund Only)Service RecognitionSupplemental Life InsuranceTraining ProgramsVoluntary AD&D InsuranceWellness:As an enterprise we understand that our employees are our greatest asset, and thattheir health is important. To ensure our employees have the opportunity to be healthyour internal health promotion program, eBalance, takes a comprehensive approachto address health and well being. The ultimate goal is an improved quality of life foremployees.eBalance is committed to establishing an environment that supports a healthylifestyle. We provide programs that address total health. An example of the offeringsprovided: incentaHEALTH (exercise, nutrition, motivation/support) Onsite education and exercise classes Financial assistance for health related products Employee Assistance ProgramTo take advantage of the many health promotion benefits you will want to enroll inthe incentaHEALTH program, as this is the portal for all eBalance programs.About this statementThis statement is based on information made available from Accident Fund/United Heartland’s records, summary plandescriptions, policy manuals, and other sources of data. All information is as of December 31, 2009 unless otherwise noted.All insurance rates and elections are as of January 1, 2010. The preparation and distribution of this statement is not deemed aguarantee of continued employment for any period.While every effort has been made to report information accurately, all details furnished, including eligibility for benefits, mustbe governed by the provisions of the plan documents. Please bring any errors to the attention of the Human Resourcesdepartment.The benefits descriptions in this statement are provided for information purposes only. Nothing in this statement should be reador interpreted to guarantee you any benefits for a specific period of time. Accident Fund/United Heartland reserves the right tochange or eliminate any of these benefits in its sole discretion to the extent allowed by applicable law.
Prepared Exclusively ForHarry Hardworker123 This StreetThattown, US 99999
ADP Cobra Services: 1-800-526-2720 BCBSM Retirement Administration: retirementadministration@bcbsm.com or 1-800- 922-0699 or (313) 225-9609 . term counseling, and referral services for a wide range of personal problems, as well as a variety of work/life issues. This benefit is 100% paid by Accident Fund.
