Page 4 - 2016 Enrollment
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Eligibility Key Medical Benefit Features
Regular full-time employees as well Our health plan administrator is UnitedHealthcare and the medical
as part-time, seasonal, temporary plans are based on United’s Choice Plus Network
and other variable hour employees Both plans are “account-based” plans which help you better manage
averaging 30 or more hours per week your healthcare costs and needs
over a deined measurement period The plans recognize and reward healthy lifestyles; in-network
are eligible for coverage in our preventive care is covered at 100 percent and you can earn company
beneits program. paid dollars toward your beneit coverage
Dependent coverage extends When you participate in the wellness program in 2016, you are eligible
to legally married spouses and to receive a contribution toward your HRA or HSA account from
dependent children. Dependent Nortek; if you have individual coverage you can earn up to $700
children include your natural child, and if you have family coverage you and your spouse can earn up to
stepchild, legally adopted child, child $1,400
placed for adoption, or a child for We partner with Vitality to help us better reward and empower your
whom your or your spouse are legal positive lifestyle changes
responsible.
Nortek Offers Four Levels of Coverage
Coverage for dependent children Employee only Employee plus child or children
continues until the end of the Employee plus spouse* Employee plus family
calendar year in which your child * Eligibility is restricted to legal spouses only.
turns 26 years of age. Unmarried
children may be eligible for
continued coverage beyond
that age if they cannot support
themselves due a mental or physical
disability. In such a case, additional Dependents Social Security Numbers
documentation is required. Employers are required to provide names and Social Security Numbers to the
federal government for each individual enrolled for medical coverage. This
You will be required to provide reporting requirement helps the federal government verify compliance with the
evidence all dependents enrolled Health Care Reform Individual Mandate.
in the health plan are eligible for If your dependent(s) has a SSN, please provide their SSN during enrollment. If
coverage (e.g., marriage/birth your dependent(s) does not have a SSN, you can still enroll them for medical
coverage; however, you will need to sign a form with UnitedHealthcare called the
certiicate, current tax iling, etc.) SSN Refusal Letter explaining why you are unable to provide SSN information for
your enrolled dependent(s). Contact HR Connect for more information.
Nortek
Eligibility Key Medical Benefit Features
Regular full-time employees as well Our health plan administrator is UnitedHealthcare and the medical
as part-time, seasonal, temporary plans are based on United’s Choice Plus Network
and other variable hour employees Both plans are “account-based” plans which help you better manage
averaging 30 or more hours per week your healthcare costs and needs
over a deined measurement period The plans recognize and reward healthy lifestyles; in-network
are eligible for coverage in our preventive care is covered at 100 percent and you can earn company
beneits program. paid dollars toward your beneit coverage
Dependent coverage extends When you participate in the wellness program in 2016, you are eligible
to legally married spouses and to receive a contribution toward your HRA or HSA account from
dependent children. Dependent Nortek; if you have individual coverage you can earn up to $700
children include your natural child, and if you have family coverage you and your spouse can earn up to
stepchild, legally adopted child, child $1,400
placed for adoption, or a child for We partner with Vitality to help us better reward and empower your
whom your or your spouse are legal positive lifestyle changes
responsible.
Nortek Offers Four Levels of Coverage
Coverage for dependent children Employee only Employee plus child or children
continues until the end of the Employee plus spouse* Employee plus family
calendar year in which your child * Eligibility is restricted to legal spouses only.
turns 26 years of age. Unmarried
children may be eligible for
continued coverage beyond
that age if they cannot support
themselves due a mental or physical
disability. In such a case, additional Dependents Social Security Numbers
documentation is required. Employers are required to provide names and Social Security Numbers to the
federal government for each individual enrolled for medical coverage. This
You will be required to provide reporting requirement helps the federal government verify compliance with the
evidence all dependents enrolled Health Care Reform Individual Mandate.
in the health plan are eligible for If your dependent(s) has a SSN, please provide their SSN during enrollment. If
coverage (e.g., marriage/birth your dependent(s) does not have a SSN, you can still enroll them for medical
coverage; however, you will need to sign a form with UnitedHealthcare called the
certiicate, current tax iling, etc.) SSN Refusal Letter explaining why you are unable to provide SSN information for
your enrolled dependent(s). Contact HR Connect for more information.
Nortek
