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Welcome to your Benefits for Nick’s Restaurants!

This guide provides a summary of your benefit op ons and is designed to help you make choices and enroll for coverage. If you
would like more informa on about any of the benefits described here, please contact the Home Office.

Contents

Important Informa on ………………………………………… 2 Online Service Assistance ……………..…………………… 9
Enrollment Informa on ……………………………………….. 3 Online Benefits Enrollment …………………………………. 9

Medical Insurance ……………………………………………….. 4 Your Monthly Contribu ons ………..…………………… 10
Vision Insurance …………………………………………………. 7 Resources and Contacts ….………………………………… 10
Dental Insurance………………………………………………….. 8

IMPORTANT INFORMATION

The Affordable Care Act and You

The Affordable Care Act (ACA) requires nearly every American to be enrolled in medical coverage or pay a penalty. This is referred
to as the individual mandate. You have several op ons to sa sfy this requirement:
 Enroll in a medical plan offered by Nick’s Restaurants or another group plan
 Purchase coverage through a health insurance marketplace
 Enroll in coverage through a government sponsored program
 Have no coverage and incur a tax penalty

The medical plans that Nick’s Restaurants offers are considered affordable and meet minimum value under Health Care Reform,
you will not generally see lower premiums or out‐of‐pocket costs through the marketplace. In addi on, employer contribu ons to
your medical benefits will be lost if you choose to purchase coverage through the marketplace, and your por on of medical
premiums will no longer be paid via payroll deduc ons on a pre‐tax basis.

For more informa on on your coverage op ons, please visit www.healthcare.gov.

Annual Notices

Various state and federal laws require that employers provide disclosure and annual no ces to their plan par cipants. Nick’s
Restaurants has posted all federally required annual no ces on PlanSource for you to download and read at your convenience.

The following is a list of the annual no ces:
 Medicare Part D No ce of Creditable Coverage
 HIPAA No ce of Privacy Prac ces
 Women's Health and Cancer Rights Act (WHCRA)
 Newborns’ and Mothers’ Health Protec on Act
 Special Enrollment Rights
 Medicaid & Children’s Health Insurance Program
 Summary of Benefits and Coverage

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