Plan Overview
Ingram
Micro maintains a comprehensive Benefit Program designed to provide financial
protection and future security for you and your family. My
Choice offers you the flexibility to design your group insurance benefit
package to suit your personal needs.
The Mandatory and
Optional Plans offer you the following coverage.
Benefit |
Bronze |
Silver |
Gold |
Medical Hospital Hearing Aids Drugs Paramedical
Services Out-of-Province
& Country Medical Emergency Emergency Global
Medical Assistance (GMA) Out-of-Pocket
Maximum |
70%
(semi-private) Not
covered 70%
- generic with card 100% - $6 dispensing fee
limit Not
Covered 100%
Unlimited N/A |
80% (semi-private) 100% 80% - generic with card 100% - $6 dispensing fee
limit 80% - $300/person/practitioner 100%
Unlimited N/A |
90% (private) 100% 90% - generic with card 100% - $10 dispensing fee
limit 90% - $500/person/practitioner 100%
Unlimited $1,000
(then 100% for all benefits) |
Dental
Preventative
/ Diagnostic Dental
Accident Basic Periodontic Endodontic Major
Restorative Orthodontics |
(Current Fee Schedule) 100% 100% Combined max. 80% $1,500/year 80% per insured 80% Not Covered Not Covered |
(Current Fee Schedule) 100% 100% Combined max. 80% $2,000/year 80% per insured 80% 50% Not Covered |
(Current Fee Schedule) 100% 100% Combined max. 80% $2,000/year 80% per insured 80% 50% 50% $2,000/lifetime max. |
Vision Care |
$150/24 months One eye exam/2 years (per year
if dependent child under age 18) |
$350/24 months One eye exam/2 years (per
year if dependent child under age 18) |
$500/24 months One eye exam/2 years (per
year if dependent child under age 18) |
Note: You must have other Medical and Dental insurance (i.e. through spouse's benefits plan) in order to Waive coverage.
Plan Overview
Benefit |
Option 1 |
Option 2 |
Option 3 |
Option 4 |
Option 5 |
Option 6 |
Short
Term Disability (STD) |
66 2/3% of weekly
salary Maximum - $2,500/wk. 0/7 waiting period 17 week benefit period |
|
||||
Long
Term Disability (LTD) |
50% of monthly earnings To age 65 benefit period |
66 2/3 of first $2,250 of monthly earnings plus 50%
of remainder To
age 65 benefit period |
66 2/3 of first $2,250 of monthly earnings plus 50%
of remainder COLA
– CPI to 3% Max. To
age 65 benefit period |
|
||
Associate
Life Insurance |
2 x Annual Salary |
3 x Annual Salary |
5 x Annual Salary |
7 x Annual Salary |
|
|
Spousal
Life Insurance |
No Coverage |
$10,000 |
$20,000 |
$50,000 |
$100,000 |
$150,000 |
Child
Life Insurance |
No Coverage |
$5,000 |
$10,000 |
$20,000 |
|
|
Accidental
Death & Dismemberment (AD&D) |
2 x Annual Salary Associate Only or Family |
3 x Annual Salary Associate Only or Family |
5 x Annual Salary Associate Only or Family |
7 x Annual Salary Associate Only or Family |
||
Associate
Critical Illness (CI) |
$5,000 |
$15,000 |
$30,000 |
$55,000 |
||
Spousal
Critical Illness (CI)
|
No Coverage |
$5,000 |
$10,000 |
$25,000 |
$50,000 |
|
Limits and other
restrictions may apply (see Plan Details in the following pages).
Various terms are used throughout this
material. The key terms that you should
be familiar with are defined below:
g
Beneficiary |
■ Individual(s) you designate in writing to receive benefits following your death. If the beneficiary you appoint is under 18 years of age, a trustee will be required before the payment can be made. |
g
Flex
Dollar Allowance |
■ The amount of money that the company provides to help you purchase the benefits you want. |
g
Coinsurance |
■ The amount the Plan reimburses you, after you have paid any required deductible. |
g
Coordination
of Benefits |
■ If you have health or dental coverage through another plan, such as your spouse’s company plan, your benefits can be coordinated with benefits from the other plan. This means that your total reimbursement for expenses may be up to 100%. |
g
Coverage
Category |
■ The level of medical, vision and dental coverage you require, that is, Employee (E) if you have no eligible dependents, Employee + 1 if you have one dependent only (child or spouse) and Employee + 2+ if you have more than one dependent (spouse and/or dependent children). |
g
Dependent |
■ Each child shall include (from birth) children of the marriage, legally adopted children and stepchildren. A child must be unmarried, not employed on a regular and full-time basis and under 22 years of age. A child age 22 to 25 inclusive will be considered a dependent if in full-time attendance at an accredited school, college or university and the student’s normal residence is in Canada. ■ Any mentally or physically handicapped child wholly dependent upon you (the Associate) for support and maintenance shall remain insured beyond any limiting age. ■ Spouse - Means the legal spouse of the Insured Person or an individual who has been residing with the Insured Person for a period of at least one year and who has been designated as the spouse of the Insured Person in the Policyholder’s records for insurance purposes. |
g
Eligibility |
■ The continuous period during which you must be actively at work before being eligible for coverage under this contract. |
g
Life
Event |
■ A Life Event is the term used to define a major event in a person’s life that may impact personal circumstances enough to warrant a benefits change in the middle of a Benefit Year. For example, the birth of a child. In the case of an eligible life event, you will have the opportunity to change your coverage choices before the next scheduled open enrollment period. You have 31 days from the date of the qualifying Life Event to change your coverage choices. Contact Human Resources to advise that you need to make a change. Eligible Life Events include: - Marriage or any other formal union recognized by law or common-law - Birth or adoption of a child - Divorce or legal separation - Loss of a spouse’s benefit coverage (proof is required) - Death of a dependent (spouse and/or children) - Loss/gain of a dependent child because of age |
g
'Waive'
Benefit Coverage |
■ If you choose to ‘Waive’ for Vision then you are restricted to the lowest benefit option should you elect coverage at a later date. If enrolled in these benefits, to ‘ Waive’ you can only do so after moving down to the lowest benefit option first. See Standard Operating Procedures on the following page for further details. ■ If you have coverage under your spouse’s plan you may waive the Medical and Dental benefits. If you subsequently lose that coverage then you can come into the ‘My Choice’ options within 31 days (for an eligible Life Event) and choose any option. |
g
Premium |
■ The annual cost for coverage under each option. Premiums can be paid using your Flex Dollar Allowance, payroll deductions, or a combination of both. |
g
Reasonable
& Customary |
■ Charges that do not exceed the general level of charges made by other providers of similar standing in the locality or geographical area where the charge is incurred, when furnishing like or comparable treatment, services or supplies. |
g
Salary |
■ Salary includes your base or regular pay, retroactive earnings, vacation and sick time, sales commissions and sales quarterly commission. Salary excludes but is not limited to, incentive plan payments of any type, SPIFFS, relocation assignment payments, IMI stock related payments, special incentive pay, gainsharing, spot bonus, awards, contests, attendance awards, car allowance or commissions for Credit Associates. |
Standard Operating Procedures
(S.O.P.s/Rules)
■ Benefit enrollment occurs one time per year.
■ Evidence of Insurability will be required on Life insurance exceeding $650,000 and LTD insurance over $12,000 on your initial enrollment and to increase coverage on subsequent re-enrollments. Evidence is required on all amounts of Spousal Life Insurance exceeding $20,000.
■ Re-enrollment between anniversary dates can occur if there is a dependent status change (i.e. single to employee +1 or +2+ or vice versa) because of marriage, divorce, birth or death. You must apply within 31 days or medical evidence will be required.
■ Re-enrollment between anniversary dates can occur if Medical and/or Dental coverage had been waived because of spousal coverage, but your spouse loses that coverage. Vision Care can also be taken if the spouse loses Medical coverage which included Vision Care. You must apply within 31 days after your spouse loses coverage or medical evidence will be required.
■ Salary changes are not an 'Eligible Life Event' and will not cause a re-enrollment.
■ For Medical, Dental and Vision Care on initial enrollment any Option can be selected; however, you must be covered under a spouse's plan to 'Waive' of Medical and Dental coverage.
■ If you select 'Waive' for Medical, Dental or Vision coverage you will only be able to come into the plan at the lowest benefit option (Bronze).
■ For Medical and Dental on subsequent re-enrollments you may only move up or down one level of coverage per year (i.e. if in Gold you must change to Silver for a year and then Bronze). You may only elect 'Waive' for Medical and Dental if you have coverage under a spouse's Medical and Dental plan.
■ For Vision on subsequent re-enrollments you may only move up or down one level of coverage per two years (i.e. if in Gold for two years, you may change to Silver for two years, then Bronze for two years and finally to the 'Waive' option.