Page 3 - NickCo Hospitality_2019 EE Benefits Guide_Hourly Associates_FINAL.2.pub
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ENROLLMENT INFORMATION





         Who May Enroll
         Per  ACA  requirement,  Nick’s  Restaurants  looks  back  over  a  defined  period  of  me  (measurement  period)  to  determine  if  the
         employee averaged at least 30 hours per week. Once the employee is determined with an average of 30 or more hours of service
         per week or 130 hours of service per month during the measurement period, you and your eligible dependents may par cipate in
         Nick’s Restaurants benefits program. Your eligible dependents include:
           Legally married spouse
           Registered domes c partner
           Children under the age of 26, regardless of student or marital status

         When You Can Enroll
         As an eligible Associate, you may enroll at the following  mes:
           As a new hire, you may par cipate in the company’s benefits program on the first day of the month following the comple on
            of 60 days of full‐ me employment
           Each year, during open enrollment
           Within 30 days of a qualifying event as defined by the IRS (see Changes To Enrollment below)

         Paying For Your Coverage
         You and the company share in the cost of the Medical and Dental benefits you elect. Any Vision benefits you elect will be paid by
         you at discounted group rates. Our Medical, Dental, and Vision contribu ons are deducted before taxes are withheld which saves
         you  tax dollars.  Paying  for benefits  before‐tax  means  that  your  share  of  the  costs  are  deducted  before  taxes are  determined,
         resul ng in more take‐home pay for you. As a result, the IRS requires that your elec ons remain in effect for the en re year. You
         cannot drop or change coverage unless you experience a qualifying event.

         Changes To Enrollment
         Our benefit plans are effec ve January 1st through December 31st of each year. There is an annual open enrollment period each
         year, during which you can make new benefit elec ons for the following January 1st effec ve date. Once you make your benefit
         elec ons,  you  cannot  change  them  during  the  year  unless  you  experience  a  qualifying  event  as  defined  by  the  IRS.  Examples
         include, but are not limited to the following:
           Marriage, divorce, legal separa on or annulment       Change in your residence or workplace (if your benefit
           Birth or adop on of a child                             op ons change)
           A qualified medical child support order                Loss of coverage through Medicaid or Children’s Health
           Death of a spouse or child                              Insurance Program (CHIP)
           A change in your dependent’s eligibility status       Becoming eligible for a state’s premium assistance
           Loss of coverage from another health plan               program under Medicaid or CHIP

         Coverage for a new dependent is not automa c. If you experience a qualifying event, you have 30 days to update your coverage.
         Please contact the Home Office immediately following a qualifying event to complete the appropriate elec on forms as needed.
         You may login to PlanSource to update your dependent informa on as needed. PlanSource login informa on is located on page 10
         of this guide. If you do not update your coverage within 30 days from the qualifying event, you must wait un l the next annual
         open enrollment period to update your coverage.



                            Online Benefits Information


                            You  can  access  your  benefits  informa on  whenever  you  want,  from  home  or  any  place
                            where you have internet access, by visi ng Springboard Marketplace. You’ll find documents
                            posted such as the Summary of Benefits and Coverage (SBC), annual no ces, carrier benefit
                            summaries, evidence of coverage booklets, claim forms, and much more.

                            Springboard Marketplace login informa on is located on page 9 of this guide.




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