Represented
Employees
Hired
on the Effective Date of the 2002 Agreement
Pension Plan |
|||
| Normal
Retirement Benefit (NRB) |
Accrued Benefit as of closing date under Boeing formula (rolled
up with earnings escalator) plus future service benefit under Chem-tronics
formula |
||
| Benefit
Formula |
.75% x FAE x SVC plus .60% x [FAE - CC] x SVC (Max 35 yrs) |
||
| Earnings
Definition |
Base Pay Only |
||
| Early
Retirement (ER) |
Accrued
benefit under Boeing plan subject to Boeing ER factors. Future service benefit -Chem-tronics plan
payable at age 55 with 10 years of service, reduced 6% per year from
age 65 to early retirement |
||
| Payout
Options |
Annuity only for Boeing benefit; lump sum or annuity for
Chem-tronics benefit |
||
Savings / 401(k)
Plan |
|||
| Employer
Match |
50% of employee deferrals (maximum 8%) for maximum match
of 4% of salary |
||
Medical (Active
and pre-65 Retirees) |
|||
| Plan
Design |
Refer to Plan Summary |
||
| Employee
Cost |
18% of the monthly premium |
||
| |
|||
| Contribution to FSA |
$100
annual minimum / $5,000 annual maximum |
||
| |
|||
| |
PPO Plan Enrollees |
% |
|
| Year
one contribution for EE Only |
$60.23 |
18% |
|
| Year
one contribution for EE+Children |
$114.44 |
18% |
|
| Year
one contribution for EE+Spouse |
$126.48 |
18% |
|
| |
PPO Plan Enrollees |
% |
|
| Year
one contribution for EE+Family |
$186.71 |
18% |
|
Dental
(Active and pre-65 Retirees) |
|||
| Plan Design |
Refer to Plan Summary |
||
| Employee Cost |
18% of the monthly premium |
||
| Vision (Active and pre-65
Retirees) |
|||
| Plan Design |
Refer to Plan Summary |
||
| Employee Cost |
50%
of the monthly premium (same as Chem-tronics percentage) |
||
| Ancillary Benefits |
|||
| Company
Paid Life Insurance |
1 x
Base Annual Earnings |
||
| Optional
Life Insurance |
Up
to $1,000,000 (employee paid) |
||
| Company
Paid Short Term Disability |
66-2/3%
Base Annual Earnings (w/offsets ie, workers’ compensation, federal/state
disability) |
||
| Company
Paid Long Term Disability |
66-2/3%
Base Annual Earnings (w/offsets ie, workers’ compensation, federal/state
disability) |
||
Represented Employees
(Active)
Hired
After the Effective Date of the 2002 Agreement
Savings / 401(k)
Plan |
|||
| Employer
Match |
50% of employee deferrals (maximum 8%) for maximum match
of 4% of salary |
||
Medical (Active
and pre-65 Retirees) |
|||
| Plan
Design |
Refer to Plan Summary |
||
| Employee
Cost |
18%
of the monthly premium |
||
| |
|||
| Contribution
to FSA |
$100
annual minimum / $5,000 annual maximum |
||
| |
|||
| |
PPO Plan Enrollees |
% |
|
| Year
one contribution for EE Only |
$60.23 |
18% |
|
| Year
one contribution for EE+Children |
$114.44 |
18% |
|
| Year
one contribution for EE + Spouse |
$126.48 |
18% |
|
| Year
one contribution for EE + Family |
$186.71 |
18% |
|
Dental
(Active and pre-65 Retirees) |
|||
| Plan Design |
Refer to Plan Summary |
||
| Employee Cost |
18% of the monthly premium |
||
| Vision (Active and pre-65
Retirees) |
|||
| Plan Design |
Refer to Plan Summary |
||
| Employee Cost |
50%
of the monthly premium (same as Chem-tronics percentage) |
||
| Ancillary Benefits |
|||
| Company
Paid Life Insurance |
1 x
Base Annual Earnings |
||
| Optional
Life Ins. |
Up
to $1,000,000 (employee paid) |
||
| Company
Paid Short Term Disability |
66-2/3%
Base Annual Earnings (w/offsets ie, workers’ compensation, federal/state
disability) |
||
| Company
Paid Long Term Disability |
66-2/3%
Base Annual Earnings (w/offsets ie, workers’ compensation, federal/state
disability) |
||
PPO BENEFITS AT A GLANCE – HIGHMARK BC/BS
| Plan Basics |
In Network |
Out-of-Network |
| Deductible
§
Individual
§
Family – maximum of
2 times individual deductible |
$100 |
$250 |
|
Annual Out-of-Pocket (OOP) maximum (does not include deductible)
§
Individual
§
Family – maximum of
2 times individual deductible |
$1,000 |
$2,000 |
| Outpatient Care |
|
|
| Surgery/Diagnostics Tests/X-Rays If treatment is sought at an in-network
facility, benefits will be covered at the in-network level for radiologist/pathologist/
anesthesiologist. |
90%* |
70%* |
| Physician
Office Visits |
$15 copay |
70%* |
| Inpatient Care |
|
|
| Hospital
Room & Board Physician Services |
90%* 90%* |
70%* 70%* |
| Emergency Care |
|
|
| Emergency
Room (waived if admitted) Benefits will be reduced if services
are received for a non emergency |
$50 copay |
$50 copay |
| Ambulance
or other emergency related charges |
90%* |
70%* |
*After deductible
| Mental Health/Chemical Dependency |
|
|
| Inpatient -30 day annual maximum, only 2 chemical dependency
treatments per lifetime
·
Hospital Room &
Board
·
Diagnostic Tests/X-Rays/Physician
Services
·
Physician Services Outpatient
·
Physician Office Visit |
90%* 90%* 90%* $15 copay |
70%* 70%* 70%* 70%* |
| Other |
|
|
| Home
Health Care/Private Duty Nursing -
$10,000 annual max Hospice |
90%* 90%* |
70%* 70%* |
| TMJ
- $5,000 lifetime maximum |
90%* |
70%* |
| Maternity
·
Initial Visit
·
Pre-Natal/Delivery/Post-Natal
Visits/Hospital Services |
$15 copay 90%* |
70%* 70%* |
| Therapy 20 visit annual maximum
·
Occupational/Physical
Therapy
·
Speech Therapy
·
Chiropractic Care (20
visit annual limit) |
$15 copay $15 copay $15 copay |
70%* 70%* 70%* |
| Pharmacy Benefits |
|
|
| Retail Generic (mandatory
generic) Brand |
$10 copay $20 copay |
70% 70% |
| Mail
Order (30 day supply) Generic Brand |
$20 copay $40 copay |
N/A N/A |
*After deductible
DENTAL BENEFITS AT A
GLANCE
| |
|
| Annual Deductible
·
Individual
·
Family |
|
| Annual
Benefit Maximum per Individual |
$1,250 |
| Coinsurance:
§
Preventive
§
Basic
§
Major |
100% 80% 50% |
| Orthodontia:
§
Coinsurance
§
Lifetime Maximum |
50% $1,250 |
VISION BENEFITS AT A GLANCE
| Plan Basics |
In-Network |
Out-of-Network |
| Eye Examination, Annually |
100% after $15 copay |
Up
to $43 reimbursement |
|
Eyeglass Lenses, Annually |
100% after $10 copay |
Up
to $35/single vision Up to $51/bifocal Up to $68/trifocal Up to $80/lenticular |
| Frames, once every two years * Up to covered allowance, approx
$120 retail |
100% after $10 copay |
Up to $45 |
| Plan Basics |
In-Network |
Out-of-Network |
| Elective Contact Lenses (In lieu of frames and lenses) |
$20 copay; max benefit $105 |
Up to $105 |
| Medically Necessary Contact Lenses |
$20 copay; max benefit |
Up to $210 |
| Discounts
·
20% off of non-covered
complete pairs of prescription glasses when provided by an in-network
provider
·
15% Discount off the
doctor’s professional services when buying contact lenses |
||