Page 4 - Benefits Guide TeleSign 2020
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Benefits at A Glance








                                                    BENEFIT CHOICES


          Medical and Prescription Drugs   •  HMO: No deductible, $20 PCP, $40 specialist, $250 hospital, prescription drugs
          Anthem Blue Cross                •  PPO: $250/$750 deductible, $20 PCP, $40 specialist, 20% hospital, prescription drugs
                                           •  HSA PPO: $1,500/$3,000 deductible, 20% PCP/specialist, 20% hospital, prescription
                                              drugs

          Health Savings Account           •  IRS Annual Maximum Contribution Limit: $3,550 Individual / $7,100 Family
          Health Equity                    •  TeleSign’s Annual Contribution: up to $750 Individual / $1,500 Family

          Flexible Spending Accounts       •  Health Care Account: Up to $2,750 per year
          Discovery Benefits               •  Limited Health Care Account: Up to $2,750 per year
                                           •  Dependent Care Account: Up to $5,000 per year

          Dental                           •  PPO: $2,500 calendar year maximum benefit, $50/$150 deductible, no charge
          Anthem Blue Cross                   preventive, 10% basic, 40% major, ortho for children 50% with $1,500 lifetime
                                              benefit maximum

          Vision                           •  PPO: $10 exam copay, $10 materials copay, $130 frames benefit, $130 contact lens
          Anthem Blue Cross                   benefit (cosmetic/elective/disposable)

          Basic Life/AD&D                  •  2x your annual salary to a maximum benefit of $500,000
          Anthem Blue Cross

          Long Term Disability             •  60% of your pre-disability earnings to a monthly maximum of $10,000
          Anthem Blue Cross


          Voluntary Life/AD&D              •  Employee: $10,000 increments to a maximum benefit of $300,000
          Anthem Blue Cross                •  Spouse or Domestic Partner: $5,000 increments to a maximum benefit of $150,000
                                           •  Child(ren): Flat $5,000 or $10,000


          Commuter Benefits                •  Transit and vanpooling: Up to $270 per year
          Discovery Benefits               •  Parking: Up to $270 per year

          Employee Assistance Program      •  24/7 unlimited phone consultations
          Anthem Blue Cross                •  Access to legal and financial counseling


          Travel Assistance Program        •  Emergency medical assistance, pre-trip information, repatriation and more when
          Anthem Blue Cross                   traveling 100+ miles away from home or work


          Value-Added Programs             •  Future Moms
          Anthem Blue Cross                •  ConditionCare
                                           •  Estimate Your Cost
                                           •  PayForward Program

          Pet Insurance                    •  5% discount on premiums
          Nationwide                       •  Helps pay for medical treatment costs for pet’s accidents, illnesses, and routine
                                              medical care, including surgeries, prescriptions, hospitalization, diagnostic tests,
                                              and office visits


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