Transcription
Employee Benefits Summary2019 Plan Year
Our employees are ourmost valuable asset.That is why at Shentel, we are committed to a comprehensive employee benefits program that helps ouremployees stay healthy, feel secure, and maintain a work/life balance. This benefit summary will review thebenefits available to employees effective January 1, 2019.STAY HEALTHY Medical Dental VisionMAINTAIN A WORK/LIFE BALANCE Employee Assistance Plan Flexible Spending AccountsFEELING SECURE Life and Accidental Death & Dismemberment Disability Insurance AccidentELIGIBILITYAll full-time employees are eligible for benefits the first of the month following 60 calendar days ofemployment. An employee is classified as full-time as long as they hold a position classified as full-time andwork at least 32 hours in a work week.Employees can make changes to their benefit elections during the year only if they have a qualifying eventas defined by the Internal Revenue Service including: A change in your legal marital status A change in the number of your dependents A change in your or your spouse’s employment that affects benefits A change in the eligibility status of a dependent A loss of benefit coverageEmployees must be enrolled or make changes within 30 days from the qualifying event. If an employeefails to do so, their next opportunity to enroll or make changes will be during Open Enrollment for coverageeffective January 1 of the following year.2SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 2019
Carrier Contact InformationMEDICAL:PAGE 4Provider Name. AnthemProvider Phone Number.800-451-1527Provider Web Address. www.anthem.comH E A LT H S A V I N G S A C C O U N T :PAGE 5Provider Name. Health EquityProvider Phone Number. 1-866-346-5800Provider Web Address. www.healthequity.comDE N TA L :PAGE 6Provider Name.GuardianProvider Phone Number.877-500-2386Provider Web Address.www.guardiananytime.comVIS IO N :PAGE 7Provider Name.GuardianProvider Phone Number.877-500-2386Provider Web Address.www.guardiananytime.comLIF E A N D ACCI DENTAL DEAT H & DISMEMB ERMENT:PAGE 8Provider Name.The StandardProvider Phone Number.888-937-4783Provider Web Address.www.Standard.comS H O RT T E R M DI SABI L I T Y:PAGE 9Provider Name.The StandardProvider Phone Number.888-937-4783Provider Web Address.www.Standard.comL O N G T E R M D I SABI L I T Y:PAGE 9Provider Name.The StandardProvider Phone Number.888-937-4783Provider Web Address.www.Standard.comE M PL O Y E E ASSI STAN CE P L AN:PAGE 9Provider Name.The StandardProvider Phone Number.888-293-6948Provider Web Address.https://workhealthlife.com/Standard3F L E XIB L E S P ENDI NG AC COUNTS:PAGE 10Provider Name. Health EquityProvider Phone Number. 1-866-346-5800Provider Web Address. www.healthequity.comVO L U N TA RY ACCI DENT I N SURA NCE:PAGE 11Provider Name.GuardianProvider Phone Number.877-500-2386Provider Web Address.www.guardiananytime.comEmployees should refer to this list when they need to contact one of the benefit vendors.For general information contact Human Resources.SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 20193
Medical InsuranceMedical insurance is offered through Anthem. Employees have a choice of two plans. The table belowoutlines and compares the employee financial exposure under each plan.Anthem KeyCare 1,000 PlanAnthem 3,000w/ HSA PlanIn-NetworkIn-Network 1,000 2,000 3,000 6,00020% Member/80% Anthem0% 4,000 8,000 5,000 10,000 15 LiveHealth Online 25 co-pay 50 co-pay0% after deductible0% after deductibleCovered at 100%Covered at 100%Emergency Services20% after deductible0% after deductibleUrgent Care Center 25 Primary Care Physician co-pay 50 Specialist co-pay0% after deductibleInpatient Hospital Stay20% after deductible0% after deductibleOutpatient Surgery20% after deductible0% after deductibleAdvanced Imaging(MRI, CT, PET)20% after deductible0% after deductibleMental HealthOutpatientInpatient20% after deductible0% after deductible0% after deductibleSubstance AbuseOutpatientInpatient20% after deductible0% after deductible0% after deductibleMandatory Generic/Mailorder* 10 / 30 / 50 / 20%** 25 / 75 / 125 / 20%*Mandatory Generic/Mailorder*After Deductible 10 / 30 / 50 / 20%**After Deductible 25 / 75 / 125 / 20%*Deductible: 1,500/ 3,000Coinsurance: 40% Member/60% AnthemOut-of-Pocket Maximum: 5,000/ 10,000Deductible: 6,000/ 12,000Coinsurance: 20%Out-of-Pocket Maximum: 10,000/ 20,000BenefitDeductible:Employee OnlyEmployee Dependent(s)CoinsuranceOut-of-Pocket MaxEmployee OnlyEmployee Dependent(s)Physician Office VisitPrimary Care SpecialistPreventive Care/Well BabyPharmacy CoverageRetail Pharmacy Co-paysHome Delivery Co-paysOut-of-Network*Mandatory mail order on maintenance prescriptions after the second refill at a retail pharmacy. You must use the mail order program for thethird refill to have the prescription covered by the insurance.**Up to 200 per monthEmployee Medical Rates Per Pay Period4Employee OnlyEmployee OneFamilyAnthem KeyCare 1,000 Plan 40.92 221.28 390.17Anthem 3,000 w/ HSA Plan 0 75.88 199.72SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 2019
Health Savings Account (HSA)If you participate in the high deductible health plan (HDHP) the IRS allows you to contribute to a HealthSavings account (HSA). The account is a tax-free medical IRA.All covered services, including prescriptions, are subject to the 3,000 deductible of the HDHP. Once anemployee meets the deductible, services will be covered by Anthem at 100% except for prescriptions.Prescriptions will be covered under three co-pay tiers of 10/ 30/ 50/20% up to 200 per month for retail and 25/ 75/ 125/20% up to 200 per month for mail order, until the out-of-pocket maximum is met. Preventativemaintenance prescriptions on the essentials list will be covered at 0 cost to the participant in the medicalplan. The list of preventative/maintenance prescriptions that are covered are listed on the last two pages ofthis booklet.The out-of-pocket maximum for the HDHP is 5,000 for employee only coverage and 10,000 for all othercoverage tiers. The deductible as well as the prescription co-pays go toward the out-of-pocket maximum.Shentel Contributions into the HSA for 2019Years of ServiceEmployee OnlyEmployee OneFamilyNew Employees w/ lessthan 1 year of service. 1,500 annually 57.69 per pay period 2,100 annually 80.79 per pay period 2,100 annually 80.79 per pay periodEmployees w/ 1 year ofservice or more. 750 prefunded 28.85 per pay period 1,500 annually 1,050 prefunded 40.38 per pay period 2,100 annually 1,050 prefunded 40.38 per pay period 2,100 annually*Shentel’s contribution will be deposited into the employee’s HSA account each pay period. Except for employees with 1 year or more of service, inwhich case half of the amount will be pre-funded at the beginning of the year with the rest being deposited each pay period until the total is met.Employees may also contribute to their Health Savings Account in addition to Shentel’s contribution asshown above. The IRS limits are the combined employee and employer contributions as shown below.HSA Contribution Limits for 2019*Coverage TierIRS Contribution LimitShentel’s ContributionEmployee Contribution LimitEmployee Only 3,500 1,500 2,000Employee One 7,000 2,100 4,900Family 7,000 2,100 4,900*Catch up contributions of 1,000 can be made by employees, who are 55 years of age or will turn 55 in the plan year, and until they enroll in Medicare.Once an employee enrolls in Medicare, the employee can no longer contribute to an HSA.Contributions limits are based on a calendar basis, which means contributions are prorated by the number ofmonths individuals are eligible to contribute to an HSA.The HSA will be administered by Health Equity and will give employees the option of investing their funds. Awelcome packet outlining the HSA details and investment options will be mailed to employees who enroll.Other key points: Investment income accumulates tax-free Any remaining balance in your HSA account at the end of each year may roll over to the following year Employees may use their debit card or check to pay for the qualified medical expenses Keep all related receipts and Explanation of Benefits for your records. You do not need to submitreceipts to be reimbursed from your HSA account.SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 20195
Dental InsuranceDental insurance is offered through Guardian. Employees are given a choice of two plans. Both plans allowemployees to seek treatment from the dentist of their choice and services are based on the usual, reasonableand customary rates in your area; there is no dental network required. If you visit a dentist that participateswith Guardian’s National PPO Network, you may pay less out-of-pocket because services are based on anegotiated contracted fee schedule. If you choose a non-participating provider, as in previous years, the planwill continue to cover your services based on the usual, reasonable and customary rates in your area. Pleasesee the chart below for a plan comparison and overview.Type of ServiceBasic OptionHigh Option 50 Individual/ 150 Family 50 Individual/ 150 Family100% Covered100% Covered80% Covered by Guardian80% Covered by GuardianMajor Services: Crowns, Bridges, Dentures,Periodontics, EndodonticsNot Covered50% Covered by GuardianOrthodontic Services*Not Covered50% Covered by Guardian 1,000 per covered member 1,500 per covered memberDeductible(Applies to Basic and Major Services Only)Preventive Services: Exams, Cleanings,Bitewing X-rays, Fluoride, SealantsBasic Services: Amalgam Filings,Simple Extractions, Denture RepairDental Annual Maximum*Lifetime maximum for orthodontic services is 1,500 for a child under age of 18.Dental Rates per Pay Period – Basic OptionEmployee OnlyEmployee SpouseEmployee Child(ren)Family 8.37 17.80 19.25 29.25Dental Rates per Pay Period – High Option6Employee OnlyEmployee SpouseEmployee Child(ren)Family 15.75 31.87 43.56 59.71SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 2019
Vision PlanA vision plan is offered through Guardian and the network is through Davis Vision. The plan offers benefitsfor regular routine eye exams, lenses, frames, and contact lenses. Please see the chart below for a plancomparison and overview.Plan FeaturePlan FrequenciesExam every 12 Months / Lenses every 12 Months / Frames every 24 MonthsCo-payment (each member)Exam 10 / Lenses and/or Frames 25Maximum AllowancesIn-NetworkOut-of-NetworkEye Exam 10 co-payment 50 maximum after 10 co-paymentLenses (per pair)SingleBifocalTrifocalLenticular 25 co-payment 25 co-payment 25 co-payment 25 co-payment 48 maximum after 10 co-payment 67 maximum after 25 co-payment 86 maximum after 25 co-payment 126 maximum after 25 co-paymentContact LensesMedically Necessary 25 co-payment 210 maximum after 25 co-payment80% of amount over 130 48 maximum after 25 co-paymentFramesVision Rates per Pay PeriodEmployee OnlyEmployee SpouseEmployee Child(ren)Family 2.99 5.03 5.12 8.11SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 20197
Basic Life Insurance& Accidental Death and DismembermentFull-time employees are provided with a Basic Life Insurance policy including Accidental Death andDismemberment paid by Shentel. Employees receive two times their annual salary up to a maximum of 600,000.Voluntary Life InsuranceFull-time employees may also choose to purchase voluntary life insurance benefits including AccidentalDeath and Dismemberment (AD&D) for themselves, their spouse and/or children when electing voluntary lifefor themselves. The coverage is provided through The Standard. Please see the plan overviews below.EMPLOYEE COVERAGE:Employees may elect coverage on themselves up to a maximum of 600,000. The guaranteed issue amountas a new hire is two times annual compensation up to 350,000, whichever is less.SPOUSE COVERAGE:Employees may elect coverage on their spouse in 5,000 increments up to 50,000 not to exceed 100% ofthe employee election. The guaranteed issue amount as a new hire is up to 25,000.CHILD(REN) COVERAGE:Employees may elect coverage on their child(ren) in the amount of 5,000. The guaranteed issue amount asa new hire is 5,000.Monthly Rate per 1,000Employee / SpouseLess than 30 0.074 / 0.07430-34 0.080 / 0.08035-39 0.100 / 0.10040-44 0.133 / 0.13345-49 0.196 / 0.19650-54 0.326 / 0.32655-59 0.498 / 0.49860-64 0.574 / 0.57465-69 1.136 / 1.13670-74 2.246 / 2.24675 ChildrenRate Per Pay PeriodAnnual Election Rateper 1,0001,000Monthly Amount 12 Months26 pay periods Per PayDeductionsExample: Employee elects 1 Salary and is 27 years of age.40,000 Salary .074 2.961,000 2.246 / 2.246 0.246 for 1,000 MonthlyAmount2.96 12 35.5226 pay periods 1.37Rates include AD&D8SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 2019
Disability InsuranceShentel provides full-time employees with short term and long term disability coverage through Standard.Employees are eligible for these benefits following 180 calendar days of employment. Employees arerequired to submit an application to The Standard to determine eligibility. In the event an employeebecomes disabled from a non work-related injury or sickness, disability income benefits are provided as asource of income. Please see the plan overviews below.Both benefits are 100% employer paid.Short Term DisabilityBenefits Begin8th Day*Maximum Benefit Period180 calendar daysPercentage of Income Replaced60% of weekly base salary*After Paid Time Off and other benefits have been exhausted, if applicableLong Term DisabilityBenefits Begin181st calendar dayMaximum Benefit PeriodSocial Security Normal Retirement AgePercentage of Income Replaced60% of weekly base salaryMaximum BenefitUp to 7,000 a monthEmployee Assistance ProgramThe Employee Assistance Program is offered to all employees and immediate family members throughThe Standard. It is a completely confidential counseling program that covers issues such as marital andfamily concerns, depression, substance abuse, grief and loss, financial entanglements, and other personalstressors.888.293.6948SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 20199
Flexible SpendingAccounts (FSA)FSA’s provide employees with an important tax advantage that can help an employee pay health care anddependent care expenses on a pre-tax basis. By anticipating one’s family’s health care and dependent carecosts for the next year, employees can actually lower their taxable income.HEALTH CARE SPENDING ACCOUNT (FSA)The FSA allows employees to pay for certain IRS-approved medical care not covered by their insuranceplan with pre-tax dollars. The Annual Maximum Contribution is 2,650. Employees may rollover amaximum of 500 at the end of the year.Some examples include: Hearing services, including hearing aids and batteries Vision services, including contact lenses, contact lens solution, eye examinations and eyeglasses Dental services and orthodontia Chiropractic services Acupuncture Prescription contraceptivesAll participants in the Health Care Spending Account will receive a new debit card from Health Equity. Thiscard will make it easier to pay for services such as co-pays for physician office visits and prescription drugs.Employees may also purchase designated over-the-counter drugs. Employees need to save their receiptsfor validation purposes if the debit card is used for expenses other than prescription and office visit copays. For non-co-pay medical expenses, employees will be asked to send in a copy of their receipts to thecarrier to validate the expense.If a debit card is not used then a claims form detailing the expenses may be submitted by email, fax or mail.You may elect a FSA if you participate in the HSA, however, you can only be reimbursed for dental andvision expenses.DEPENDENT CARE SPENDING ACCOUNT (FSA)Employees can use pre-tax dollars toward qualified dependent care expenses such as caring for childrenunder the age 13 or caring for elders. The annual maximum amount an employee may contribute to theDependent Care FSA is 5,000 (or 2,500 if married and filing separately) per calendar year. Examplesinclude: The cost of child or adult dependent care The cost for an individual to provide care either in or out of your house as long as the provider isclaiming the amount on taxes Nursery schools and preschools (excluding kindergarten)10SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 2019
Voluntary Accident InsuranceGuardian’s Voluntary Accident Insurance covers a wide variety of injuries and accident related expenses,such as emergency room treatment, hospitalization/hospital intensive care, therapy services, transportationand lodging associated with the loss of income due to a covered off-the job accident. This accidentinsurance is separate from the medical insurance and the claims are paid directly to the employee.Accident coverage provides a lump sum benefit based on the type of injury (or covered incident) theemployee sustains or the type of treatment the employee needs. The accident policy also provides awellness benefit. Each covered individual will automatically receive 100 annually for receiving a coveredhealth screening test.OPTIONAL COVERAGE INCLUDES SICKNESS HOSPITAL CONFINEMENT BENEFIT Benefit pays the employee, the employee’s spouse or child(ren) a daily benefit if he or she is in thehospital for a covered illness.The benefit amount is 150 per day up to 20 days per covered accident.RATES PER PAY PERIODEmployee OnlyEmployee SpouseEmployee Child(ren)Two ParentEmployee FamilyAccident with 100 Wellness 5.19 8.96 9.37 13.14Sickness Hospital Confinement Benefit 5.47 9.50 9.78 13.80Sickness rider is guarantee issue for initial enrollment.Please see Guardian materials for further plan details and per pay period pricing for Employee, Spouse and Dependent Children coverage.SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 201911
Premium Assistance UnderMedicaid and the Children’sHealth Insurance Program (CHIP)If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from youremployer, your state may have a premium assistance program that can help pay for coverage, using fundsfrom their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, youwon’t be eligible for these premium assistance programs but you may be able to buy individual insurancecoverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below,contact your State Medicaid or CHIP office to find out if premium assistance is available.If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of yourdependents might be eligible for either of these programs, contact your State Medicaid or CHIP office ordial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state ifit has a program that might help you pay the premiums for an employer-sponsored plan.If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligibleunder your employer plan, your employer must allow you to enroll in your employer plan if you aren’t alreadyenrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60days of being determined eligible for premium assistance. If you have questions about enrolling in youremployer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).If you live in one of the following states, you may be eligible for assistance paying your employerhealth plan premiums. The following list of states is current as of July 31, 2018. Contact your State formore information on eligibility.ALABAMA – MEDICAIDWebsite: http://myalhipp.com/Phone: 1-855-692-5447ALASKA – MEDICAIDThe AK Health Insurance Premium Payment ProgramWebsite: http://myakhipp.com/Phone: 1-866-251-4861Email: CustomerService@MyAKHIPP.comMedicaid Eligibility: aspxARKANSAS – MEDICAIDWebsite: http://myarhipp.com/Phone: 1-855-MyARHIPP (855-692-7447)COLORADO – HEALTH FIRST COLORADO(COLORADO’S MEDICAID PROGRAM) & CHILDHEALTH PLAN PLUS (CHP )Health First Colorado Website:https://www.healthfirstcolorado.com/Health First Colorado Member Contact Center:1-800-221-3943/ State Relay 711CHP : Colorado.gov/HCPF/Child-Health-Plan-PlusCHP Customer Service: 1-800-359-1991/State Relay 71112FLORIDA – MEDICAIDWebsite: http://flmedicaidtplrecovery.com/hipp/Phone: 1-877-357-3268GEORGIA – MEDICAIDWebsite: http://dch.georgia.gov/medicaidClick on Health Insurance Premium Payment (HIPP)Phone: 404-656-4507INDIANA – MEDICAIDHealthy Indiana Plan for low-income adults 19-64Website: http://www.in.gov/fssa/hip/Phone: 1-877-438-4479All other MedicaidWebsite: http://www.indianamedicaid.comPhone 1-800-403-0864IOWA – MEDICAIDWebsite: http://dhs.iowa.gov/hawk-iPhone: 1-800-257-8563SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 2019
KANSAS – MEDICAIDWebsite: http://www.kdheks.gov/hcf/Phone: 1-785-296-3512KENTUCKY – MEDICAIDWebsite: https://chfs.ky.govPhone: 1-800-635-2570LOUISIANA – MEDICAIDWebsite: Phone: 1-888-695-2447MAINE – MEDICAIDWebsite: dex.htmlPhone: 1-800-442-6003TTY: Maine relay 711MASSACHUSETTS – MEDICAID AND CHIPWebsite: th/Phone: 1-800-862-4840MINNESOTA – MEDICAIDWebsite: her-insurance.jspPhone: 1-800-657-3739MISSOURI – MEDICAIDWebsite: htmPhone: 573-751-2005MONTANA – MEDICAIDWebsite: Phone: 1-800-694-3084NEBRASKA – MEDICAIDWebsite: http://www.ACCESSNebraska.ne.govPhone: (855) 632-7633Lincoln: (402) 473-7000Omaha: (402) 595-1178NEVADA – MEDICAIDMedicaid Website: http://dhcfp.nv.govMedicaid Phone: 1-800-992-0900SOUTH DAKOTA - MEDICAIDWebsite: http://dss.sd.govPhone: 1-888-828-0059SHENTEL EMPLOYEE BENEFITS SUMMARY PLAN YEAR 2019NEW HAMPSHIRE – MEDICAIDWebsite: https://www.dhhs.nh.gov/ombp/nhhpp/Phone: 603-271-5218Hotline: NH Medicaid Service Center at 1-888-901-4999NEW JERSEY – MEDICAID AND CHIPMedicaid Website: /medicaid/Medicaid Phone: 609-631-2392CHIP Website: http://www.njfamilycare.org/index.htmlCHIP Phone: 1-800-701-0710NEW YORK – MEDICAIDWebsite: https://www.health.ny.gov/health care/medicaid/Phone: 1-800-541-2831NORTH CAROLINA – MEDICAIDWebsite: https://dma.ncdhhs.gov/Phone: 919-855-4100NORTH DAKOTA – MEDICAIDWebsite: d/Phone: 1-844-854-4825OKLAHOMA – MEDICAID AND CHIPWebsite: http://www.insureoklahoma.orgPhone: 1-888-365-3742OREGON – MEDICAIDWebsite: //www.oregonhealthcare.gov/index-es.htmlPhone: 1-800-699-9075PENNSYLVANIA – MEDICAIDWebsite: hone: 1-800-692-7462RHODE ISLAND – MEDICAIDWebsite: http://www.eohhs.ri.gov/Phone: 855-697-4347SOUTH CAROLINA – MEDICAIDWebsite: https://www.scdhhs.govPhone: 1-888-549-0820WASHINGTON – MEDICAIDWebsite: ne: 1-800-562-3022 ext. 1547313
TEXAS – MEDICAIDWEST VIRGINIA – MEDICAIDWebsite: http://gethipptexas.com/Phone: 1-800-440-0493Website: http://mywvhipp.com/Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)UTAH – MEDICAID AND CHIPWISCONSIN – MEDICAID AND CHIPMedicaid Website: https://medicaid.utah.gov/CHIP Website: http://health.utah.gov/chipPhone: 1-877-543-7669Website: 95.pdfPhone: 1-800-362-3002VERMONT– MEDICAIDWYOMING – MEDICAIDWebsite: http://www.greenmountaincare.org/Phone: 1-800-250-8427Website: https://wyequalitycare.acs-inc.com/Phone: 307-777-7531VIRGINIA – MEDICAID AND CHIPMedicaid Website: http://www.coverva.org/programs premiumassistance.cfmMedicaid Phone: 1-800-432-5924CHIP Website: http://www.coverva.org/programs premiumassistance.cfmCHIP Phone: 1-855-242-8282To see if any other states have added a premium assistance program since July 31, 2018, or for moreinformation on special enrollment rights, contact either:U.S. Department of LaborU.S. Department of Health and Human ServicesEmployee Benefits Security AdministrationCenters for Medicare & Medicaid 866-444-EBSA (3272)1-877-267-2323, Menu Option 4, Ext. 61565PAPERWORK REDUCTION ACT STATEMENTAccording to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required torespond to a collection of information unless such collection displays a valid Office of Management andBudget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor acollection of information unless it is approved by OMB under the PRA, and displays a currently valid OMBcontrol number, and the public is not required to respond to a collection of information unless it displays acurrently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law,no person shall be subject to penalty for failing to comply with a collection of information if the collection ofinformation does not display a currently valid OMB control number. See 44 U.S.C. 3512.The public reporting burden for this collection of information is estimated to avera
Shentel Contributions into the HSA for 2019 Years of Service Employee Only Employee One Family New Employees w/ less than 1 year of service. 1,500 annually 57.69 per pay period 2,100 annually 80.79 per pay period 2,100 annually 80.79 per pay period Employees w/ 1 year of service or more. 750 prefunded 28.85 per pay period
