Benefits Overview - Out of State
/Koam Engineering Systems, Inc. - Benefit Overview Effective February 1, 2013
Through the KES, Inc. Group Health Plan participants have the opportunity to choose benefits that are best suited to their needs. Our benefit program includes generous provisions for vacations, holidays, retirement and insurance coverage. To be eligible for benefits participants must work a fixed schedule of at least 20 or more hours per week. The following provides a summary of each benefit.
Medical Plans
Eligible participants have a PPO medical option available with Health Net.
Participants may also choose not to elect medical coverage for themselves or their dependents. If medical coverage is not elected and participants later want to enroll in a medical plan they must wait until the next annual open enrollment period takes place in January each year or if a qualifying event occurs (i.e., loss of current medical coverage, spouses loss of current medical coverage, marriage, birth of child, adoption etc.).
Health Net PPO - Health Net PPO provides the greatest amount of flexibility and choice in selecting medical providers. There's no annual deductible prior to receiving any benefits within the Health Net Network. Office visits require a $10 co-pay, while hospitalization etc are covered at 80% with a maximum out-of-pocket expenses of $3,000.00 (per member/year) when using doctors within the Health Net PPO network. Coverage outside of the network is covered at 60% with a maximum out-of-pocket expense of $6,000. The annual deductible when receiving benefits outside the Health Net Network is $250 per person. The monthly premium is covered at 80% for regular full time employees and their family. Please see the plan for more detail.
Dental Plans
Eligible participants have a PPO dental option available with Guardian Dental Insurance.
Participants may also choose not to elect dental coverage for themselves or their dependents. If dental coverage is not elected and participants later want to enroll in a dental plan they must wait until the next annual open enrollment period takes place in January each year or if a qualifying event occurs (i.e., loss of current dental coverage, spouses loss of current dental coverage, marriage, birth of child, adoption etc.).
Guardian PPO Plan - Guardian PPO members are required to pay an annual deductible of $50.00 per member (max of three family members). Preventative services are paid at 100%, regular services are covered at 90% and major services are covered at 60% within the network. There is a maximum benefit of $2,000.00 per year in-network and $1500.00 per year out-of-network. This plan doesn't cover orthodontic services.
Maximum Rollover: With Maximum Rollover, Guardian will roll over a portion of each member's unused annual maximum, called the Maximum Rollover Amount, into his or her Maximum Rollover Account (MRA). The MRA can be used in future years, if a member reaches the plan's Annual Maximum. Even better, if a member uses the services of Preferred Providers exclusively during the benefit year, we'll increase the amount credited to his or her MRA to the In-network Only Maximum Rollover Amount. To qualify, a member must submit a claim and not exceed the paid claims Threshold during the benefit year. The employee and each insured dependent maintain separate MRAs based on their own claim activity. Each member's MRA may not exceed the MRA limit.
Plan Annual Maximum- $1,500.00
Threshold- $700.00
Maximum Rollover Amount-$350.00
In-Network Only Maximum Rollover Amount- $500.00
Maximum Rollover Account Limit- $1,250.00
*If a plan has a different annual maximum for PPO benefits vs. non-PPO benefits, ($1500 PPO/$1000 non-PPO for example) the non-PPO maximum determines the Maximum Rollover plan.
The monthly premium is covered at 80% for regular full time employees and their family. Please see the plan for more details.
Vision Plan (100% of Premiums Paid by Employee)
Eligible participants have a PPO vision option available with Guardian VSP Vision - The plan provides full coverage for covered services and or materials when you go to a participating provider. This coverage includes:
Annual eye exam (Once every 12 months) a $10 co-pay Lenses (Once every 12 months) One pair of single vision lenses, bifocal lenses or trifocal lenses for a $0 co-pay. Frames (Once every 12 months) No co-pay, up to $120 retail value - receive 20% off balance over plan allowance Contact Lenses (Once every 12 months) elective, conventional and disposable contact lenses: no co-pay, up to $120 retail value. Non-elective contact lenses no co-pay.
AFLAC (100% of Premiums Paid by Employee) Personal Disability Income Protection - Short Term Disability Insurance: Our Personal Short-Term Disability insurance may help provide you with a source of income if you become disabled due to a sickness or off-the-job injury. It provides monthly benefits for periods of 6 months, 12 months or 24 months. When you own AFLAC's Personal Short-Term Disability insurance, your policy stays with you regardless of job change.
Personal Indemnity Plan - Accident Only Insurance: A disabling injury occurs in the home about every four seconds. Our Personal Accident Plan is designed to help cover the expenses associated with an accidental injury. It pays you directly, unless you assign benefits, regardless of any other insurance you may have. Benefits are determined by state, but include:
Initial treatment benefit Accident hospital confinement Accidental death and dismemberment Wellness Benefit Personal Indemnity Plan - Cancer Indemnity Insurance: According to the American Cancer Society, in the United States, men have a little less than a 1-in-2 lifetime risk of developing cancer; for women the risk is a little more than 1-in-3. Although health insurance can help offset the costs of cancer treatment, you still may have to cover deductibles and co-payments on your own. Additionally, cancer treatment can cause out-of-pocket expenses that aren't covered by traditional health insurance. Benefits include, but are not limited to:
First-occurrence benefit Hospital confinement Radiation and chemotherapy National Cancer Institute (NCI) evaluation/consultation Wellness Benefit Specified Health Event Protection: Medical science and early, fast detection have increased survival rates for many serious medical conditions. AFLAC provides the financial assistance to help you get back on your feet if you are faced with expensive treatment and loss of income for any of the following specified health events: Heart attack, Coma, End-Stage Renal Failure, Stroke, Paralysis, Major Human Organ Transplant, Coronary Artery Bypass Surgery, Major third-Degree Burns.
Benefits include, but are not limited to:
- First-Occurrence Benefit
- Reoccurrence Benefit
- Hospitalization
Continuing Care
Hospital Protection - Hospital Confinement Indemnity Insurance: AFLAC will pay the amount listed below for the first five days of hospitalization when a covered person requires hospital confinement for a covered sickness or injury and a charge is incurred.Sickness - $400 a day
- Injury - $500 a day
Employee Assistance Program (No Cost to Employee)
Guardian Work Life Matters: An Employee Assistance Program: An EAP plan allows you or your family members that live with you a wide range of services covering issues ranging from daily living and wellness to more complex behavioral health issues such as family and marital relationship problems. Counselors are available for you to meet with in person or to talk to on the phone based on the situation.
AMB Flexible Spending Plan ($5.00 Monthly Cost to Employee)
The Flexible spending plan allows for certain medical and dependent care expenses not reimbursed by insurance program to be paid with pre-tax dollars rather than after-tax dollars, reducing your taxes. The medical expenses are deducted from your paycheck on a pre-tax basis and reimbursed to you on the same check, with tax-free dollars.
What expenses are covered under the Flex plan?
- Medical plan deductibles
- Most co-payments
- Prescription drugs
- Routine checkups and physicals
- Vision care expenses including: exams, glasses and contact lenses
- Laser eye surgery
- Many treatments of alcoholism or drug addiction
- Smoking cessation programs and prescriptions prescribed by a physician
- Medically necessary cosmetic surgery
- Hearing aids/batteries
- Birth control pills, devices and procedures
- Sterilization and vasectomy
- Well baby care and immunizations
- Chiropractor expenses for medical care
- Infertility treatments
- Massage therapy used to treat injury of trauma
- Weight loss programs prescribed to treat an existing condition
- Acupuncture or related procedures when treating a medical condition
AMB Dependent Care ($5.00 Monthly Cost to Employee)
AMB Dependent care allows you to run your dependent care cost through the plan with pre-tax dollars up to $5,000 per year. Dependent care costs include: day care and before and after school programs for children 13 years and younger.
The unreimbursed dependent care expenses are deducted from your paycheck on a pre-tax basis and reimbursed to you on the same check, with tax-free dollars.
Guardian Group Life/ AD&D Insurance (No Cost to Employee) KES provides its employees with group life insurance of an amount equal to 1 times the employee's annual earnings to a maximum of $250,000. All full time-time employees who work a minimum 30 hours a week are covered under this plan at no cost to the employee.
Guardian Voluntary Life Insurance (100% of Premiums Paid by Employee) KES provides its employees the option to purchase additional voluntary life insurance for themselves, their spouses and their children. This additional life insurance is paid 100% by the employee. This policy is portable and can be converted to a personal life insurance policy upon the conclusion of your employment with KES, Inc. at your request.
Northwestern Long-Term Disability Insurance
The group Long Term Disability plan (LTD) will provide eligible employees some income replacement in the event they are unable to work due to a long term disability.
- Benefits become available after the 91st day of a disability.
North Western Long Term Disability Plan - Voluntary Plan: KES, Inc's voluntary LTD program will allow employees to carry their own supplemental LTD plan at a group discounted rate. Interested employees will individually fill out an application and go through an underwriting process. Employees are responsible for 100% of the premium which will be set up as an after tax deduction taken from your paycheck. Since the benefit is an after tax deduction all benefits received from the plan will not be taxable income. Voluntary plans have more flexibility therefore can be customized to meet each employee's specific needs and are completely portable. Rates will vary depending on the structure of your plan.
401(k) Plan KES offers a 401(k) plan to all employees. Employees may enroll into the 401(k) plan upon date of hire or at anytime thereafter. Employees are allowed to make a pre-tax or Roth post-tax contribution not to exceed $17,500.00 per year as set by the IRS guidelines. In addition, all full-time employees receive a monthly contribution to their 401(k) equal to 3% of their salary which is effective upon date of hire.
Employee Stock Ownership Plan (ESOP) (Discretionary Plan) An employee stock ownership plan (ESOP) is a type of tax-qualified employee benefit plan in which most or all of the assets are invested in stock of the employer. Like profit sharing and 401(k) plans, which are governed by many of the same laws, an ESOP generally must include at least all full-time employees meeting certain age and service requirements. Employees do not actually buy shares in an ESOP instead the company contributes its own shares to the plan and contributes cash to buy its own stock. Employees gradually vest in their accounts and receive their benefits when they leave the company.
Education Assistance
KES feels an individual who possesses a desire to continue their education in addition to performing their full-time job, shows a commitment to improving themselves and their position within the company. To encourage and reward these individuals, KES offers an Education Assistance Benefit.
Paid Time Off
Holidays: Employees are eligible for 10 paid holidays each calendar year.
Vacation: Employees are eligible to earn up to 3 weeks of vacation per year. Employees with more than 10 years of service are eligible to earn up to 4 weeks of vacation per year. Vacation hours are accrued each pay period and employees are eligible to take vacation hours as they are earned.
Sick Leave: Employees are eligible to earn up to 5 days of sick leave per year. Sick leave is accrued each pay period and employees are eligible to take sick hours as they are earned.