Page 2 - United Capital EE Guide 04-18 PFE

ENROLLMENT INFORMATION

WHO MAY ENROLL
If you are a regular, full-time employee working at least 30 hours per week, you and your eligible dependents may participate in
The PFE Group’s benefits program. Your eligible dependents include:
z Legally married spouse
z Registered domestic partner
z Children under the age of 26, regardless of student or marital status

WHEN YOU MAY ENROLL

As an eligible employee, you may enroll at the following times:
z As a new hire, you may participate in the company’s benefits program on the first day of the month following your date of hire
Welcome to The PFE Group! This guide provides a summary of your z Each year, during open enrollment
benefit options and is designed to help you make choices and enroll z Within 30 days of a qualifying event as defined by the IRS (see Changes To Enrollment)
for coverage. If you would like more information about any of the z You may enroll in Voluntary Short Term Disability, Voluntary Long Term Disability, and Voluntary Accident Insurance at any time
benefits described here, please contact your HR Representative. z You may enroll in Voluntary Life/AD&D and Voluntary Critical Illness at any time, subject to proof of good health and carrier
approval

PAYING FOR YOUR COVERAGE
The Employee Assistance Program and Basic Life/AD&D benefits are provided at no cost to you and are paid entirely by The PFE
Group. You and the company share in the cost of the Medical benefits you elect. Any Dental, Vision, Voluntary Life/AD&D, Voluntary
CONTENTS Short Term Disability, Long Term Disability, and Supplemental (Voluntary Accident, Voluntary Critical Illness, and Hospital Care) benefits
you elect will be paid by you at discounted group rates. Your Medical, Dental, and Vision contributions 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
Enrollment Information ...........................................................................................................................................3 taxes are determined, resulting in more take-home pay for you. As a result, the IRS requires that your elections remain in effect for
Online Benefits Enrollment .....................................................................................................................................4 the entire year. You cannot drop or change coverage unless you experience a qualifying event.

Important Information .............................................................................................................................................5
CHANGES TO ENROLLMENT
Medical Insurance ......................................................................................................................................................6 Our benefit plans are effective April 1st through March 31st of each year. There is an annual open enrollment period each year,
Cigna’s Value-Added Programs .............................................................................................................................9 during which you can make new benefit elections for the following April 1st effective date. Once you make your benefit elections,
you cannot change them during the year unless you experience a qualifying event as defined by the IRS. Examples include, but are
Dental Insurance .........................................................................................................................................................12 not limited to the following:
z Marriage, divorce, legal separation or annulment
Employee Assistance Program ..............................................................................................................................13 z Birth or adoption of a child
Vision Insurance ..........................................................................................................................................................14 z A qualified medical child support order
z Death of a spouse or child
Life and AD&D Insurance .........................................................................................................................................15 z A change in your dependent’s eligibility status

Disability Insurance ...................................................................................................................................................16 z Loss of coverage from another health plan
z Change in your residence or workplace (if your benefit options change)
Flexible Spending Accounts ...................................................................................................................................17 z Loss of coverage through Medicaid or Children’s Health Insurance Program (CHIP)
z Becoming eligible for a state’s premium assistance program under Medicaid or CHIP
Commuter Benefit Plan ............................................................................................................................................18
Supplemental Benefits .............................................................................................................................................18 Please note that coverage for a new dependent is not automatic. If you experience a qualifying event, you have 30 days to update
your coverage. You may log in to Ultimate to update your dependent information as needed. If you do not update your coverage
Resources and Contacts ...........................................................................................................................................19 within 30 days from the qualifying event, you must wait until the next annual open enrollment period to update your coverage.

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