Page 4 - Practice
P. 4
Suites 3 — balanced
Cover design Suite 3 Back cover Suite 3
20XX
BENEFITS
ENROLLMENT GUIDE This Beneit Enrollment Guide is only intended to highlight some of
the major beneit provisions of the Company plan and should not be
relied upon as a complete detailed representation of the plan. Please
refer to the plan’s Summary Plan Descriptions for further detail.
Should this guide difer from the Summary Plan Descriptions, the
Summary Plan Descriptions prevail.
This publication contains important information
about your employee benefit program.
Please read thoroughly. [Rev 01/13/20] RL\EB\EE Communications\BE Suite Templates\2020-21\Suite 3\Untitled-2.pdf
© 2020 Lockton, Inc. All rights reserved.
Inside spread design Suite 3
20XX [Company Name] Benefits Enrollment Guide
What is a Network? Medical and Vision Finding In-Network Providers
A network is a group of providers your plan contracts with at Prescription Drug We partner with [Carrier] to offer you and your family Remember to visit in-network dentists to receive the deepest
discounted rates. You will almost always pay less when you members vision insurance. Visit www.[Carrier].com level of discount on your services.
receive care in-network. [Client Name] partners with [carrier] to offer medical to ind in-network providers and access to a variety of To ind a participating in-network provider in your area go to
If you choose to see an out-of-network provider, you may and prescription drug insurance. online tools and programs. [website.com] or call [555.555.5555].
be balance billed, which means you will be responsible for
charges above [Carrier]’s reimbursement amount. Plan Highlights In-Network Out-of-Network
You have the option of choosing one of [X] plans. Copay
Exam
Important Insurance Terms Our plans offer coverage for most healthcare services. Materials
When you receive care in-network you beneit from our
Deductible: the amount of money you are responsible negotiated discounts with [Carrier]. Lenses
for paying up-front before your plan shares your costs Single
Coinsurance: the percentage you and the plan pay; in [Carrier] Member Site Bifocal
Trifocal
our plans, you pay a smaller percentage and the plan Visit www.[Carrier].com to take advantage of all Lenticular
pays a larger percentage the helpful tools and resources available including the Frames
Copay: a ixed amount for certain services you pay in following.
some of our plans Contacts
Out-of-pocket maximum: the limit on your In-network provider and pharmacy searches
expenses; once you reach this limit, the plan covers all A list of prescription drugs covered by our plans Frequency
eligible expenses for the remainder of the plan year Exam
Access to temporary ID cards and means to order
another ID card Lenses
glasses)
Information regarding paid and pending claims Contacts (in lieu of
Frames
Employee [Monthly/Weekly/Bi-
Weekly] Medical Contributions This is a high level summary of your beneit coverage. Full coverage
details are available in your summary plan description (SPD). In the
event there is a discrepancy between what is relected in this guide and
[Plan 1] [Plan 2] what is communicated in your SPD, the terms of your SPD will prevail.
Employee Only $ $
Employee and $ $ Employee [Monthly/Weekly/Bi-
Spouse Weekly] Vision Contributions
Employee and $ $
Child(ren) Employee Only $
Family $ $ Employee and Spouse $
Employee and Child(ren) $
Family $
4 9
Cover design Suite 3 Back cover Suite 3
20XX
BENEFITS
ENROLLMENT GUIDE This Beneit Enrollment Guide is only intended to highlight some of
the major beneit provisions of the Company plan and should not be
relied upon as a complete detailed representation of the plan. Please
refer to the plan’s Summary Plan Descriptions for further detail.
Should this guide difer from the Summary Plan Descriptions, the
Summary Plan Descriptions prevail.
This publication contains important information
about your employee benefit program.
Please read thoroughly. [Rev 01/13/20] RL\EB\EE Communications\BE Suite Templates\2020-21\Suite 3\Untitled-2.pdf
© 2020 Lockton, Inc. All rights reserved.
Inside spread design Suite 3
20XX [Company Name] Benefits Enrollment Guide
What is a Network? Medical and Vision Finding In-Network Providers
A network is a group of providers your plan contracts with at Prescription Drug We partner with [Carrier] to offer you and your family Remember to visit in-network dentists to receive the deepest
discounted rates. You will almost always pay less when you members vision insurance. Visit www.[Carrier].com level of discount on your services.
receive care in-network. [Client Name] partners with [carrier] to offer medical to ind in-network providers and access to a variety of To ind a participating in-network provider in your area go to
If you choose to see an out-of-network provider, you may and prescription drug insurance. online tools and programs. [website.com] or call [555.555.5555].
be balance billed, which means you will be responsible for
charges above [Carrier]’s reimbursement amount. Plan Highlights In-Network Out-of-Network
You have the option of choosing one of [X] plans. Copay
Exam
Important Insurance Terms Our plans offer coverage for most healthcare services. Materials
When you receive care in-network you beneit from our
Deductible: the amount of money you are responsible negotiated discounts with [Carrier]. Lenses
for paying up-front before your plan shares your costs Single
Coinsurance: the percentage you and the plan pay; in [Carrier] Member Site Bifocal
Trifocal
our plans, you pay a smaller percentage and the plan Visit www.[Carrier].com to take advantage of all Lenticular
pays a larger percentage the helpful tools and resources available including the Frames
Copay: a ixed amount for certain services you pay in following.
some of our plans Contacts
Out-of-pocket maximum: the limit on your In-network provider and pharmacy searches
expenses; once you reach this limit, the plan covers all A list of prescription drugs covered by our plans Frequency
eligible expenses for the remainder of the plan year Exam
Access to temporary ID cards and means to order
another ID card Lenses
glasses)
Information regarding paid and pending claims Contacts (in lieu of
Frames
Employee [Monthly/Weekly/Bi-
Weekly] Medical Contributions This is a high level summary of your beneit coverage. Full coverage
details are available in your summary plan description (SPD). In the
event there is a discrepancy between what is relected in this guide and
[Plan 1] [Plan 2] what is communicated in your SPD, the terms of your SPD will prevail.
Employee Only $ $
Employee and $ $ Employee [Monthly/Weekly/Bi-
Spouse Weekly] Vision Contributions
Employee and $ $
Child(ren) Employee Only $
Family $ $ Employee and Spouse $
Employee and Child(ren) $
Family $
4 9
