Our 2021 Savers plan includes a Health Savings Account, or HSA, allowing you to use pre-tax
funds deducted from your paycheck to pay for qualified healthcare expenses.
You can invest your HSA funds, roll them over from year to year, and use them to pay
for medical, dental, vision, prescription, and other health-related costs.
As part of Learning Care Group’s ongoing commitment to wellness and a tobacco free workplace
a tobacco surcharge will be applied if you or any family member are enrolled and are a
tobacco user.
A tobacco user is defined as a person who has smoked or used any tobacco products, such as
cigarettes (including but not limited to electronic or e-cigarettes), cigars or smokeless
tobacco products one or more times a week consistently.
The surcharge will be an additional bi-weekly paycheck deduction in the amount of $50.00.
The surcharge will cease if the tobacco user(s) quit in calendar year 2019.
As an alternative option to assist you and/or your family member, Learning Care Group offers
a Tobacco Cessation Program through Aetna. This free service is designed to help you
understand the harms of smoking and the benefits of quitting. Having a support mechanism
through the Aetna Tobacco Cessation Program will improve your
chances for success.
In-Network Benefits | Basic Plan | Enhanced Plan | Savers Plan |
---|---|---|---|
Preventive Care | Plan pays 100% | Plan pays 100% | Plan pays 100% |
What's the deductible? Individual/Family |
$2,000 / $6,000 | $500 / $1,500 | $1,400 (employee only coverage), $2,800 (employee + child(ren), and/or spouse, family) |
What's the most I will have to pay in a
year? Individual/Family |
$5,000 / $12,500 | $4,000 / $8,000 | $4,200 (employee only coverage), $8,400 (employee + child(ren), and/or spouse, family) |
What will a doctor/specialist visit cost? | $25 copay / $50 copay | 1st 3 PCP visits free, then $50 copay / $50 copay | 20% after deductible |
What will virtual care cost with CirrusMD? | FREE! | FREE! | $5 consult fee |
What will inpatient services cost? | You pay 20% after deductible | $500 copay | You pay 20% after deductible |
What will a trip to the emergency room cost? | True emergency: $350 copay Not True: $500 copay |
True emergency: $250 copay Not True: $500 copay |
True emergency: 20% after deductible Not True: 20% after deductible |
Pharmacy
Preventive Generic Preferred Brand Non-Preferred Brand Specialty |
Based on Rx tiers $15 copay $45 copay $80 copay 25% coinsurance up to $250 |
Based on Rx tiers $10 copay 30% coinsurance up to $50 50% coinsurance up to $100 25% coinsurance up to $250 |
Deductible Waived $15 copay after deductible $45 copay after deductible $80 copay after deductible 25% coinsurance after deductible up to $250 |
Pays $60 ($75 New Patient) per day (3 days)
Pays $200 per day (90 days)
Pays $40 per day (3 days)
Doctor – Pays $50 per day (1 day)Accident – Pays $500 per day (2 days)Sickness – Pays $50 per day (3 days)
Generic – Pays $25 per day (7 days)
Summary of Benefits
Summary of Benefits and Coverage
Who is able to sign up for this plan?
All Regular Full-time and Regular Part-time employees.
We encourage you to closely review the Benefit Summary for this plan. This plan provides
limited benefits which help to make it affordable. Certain key health insurance
fundamentals
are not covered so it’s important that you know what you are purchasing. Full Benefit
Summary is available in the Document Library in the Info Center on LCG360.
Visit
LCG360 to view
your
rates →
Learning Care Group offers another option for medical insurance through Reliance Standard
(RSLI). (Note, individuals residing in Massachusetts are not eligible for this plan.)
This plan provides limited benefits for specific services while providing cost effective
coverage options. It is called a limited plan because it doesn’t cover chronic
conditions
like major medical plans. However, this RSLI plan does ensure compliance with the
Affordable
Care Act which requires you to obtain health insurance coverage. Under the RSLI plan
option,
preventive care benefits are covered at 100%.
This means that you and your covered family members are able to obtain an annual
physical,
as well as many other annual preventive care services such as a colonoscopies for adults
50+, and well woman exams. Because preventive care services are covered at 100%, the RSLI
Plan is compliant with the Affordable Care Act.
Summary of
Benefits and Coverage →
Benefits
Brochure →
Bi-Weekly Rates
Tobacco Surcharge
Summary of Benefits and Coverage
Summary Plan Description
In-Network Benefits | Basic Plan | Enhanced Plan | Savers Plan |
---|---|---|---|
Pharmacy
Preventive Generic Preferred Brand Non-Preferred Brand Specialty |
Based on Rx tiers $15 copay $45 copay $80 copay 25% coinsurance up to $250 |
Based on Rx tiers $10 copay 30% coinsurance up to $50 50% coinsurance up to $100 25% coinsurance up to $250 |
Deductible Waived $15 copay after deductible $45 copay after deductible $80 copay after deductible 25% coinsurance after deductible up to $250 |
Benefits | Basic Plan |
Enhanced Plan |
---|---|---|
Annual Deductible | $50 Individual and $150 per Family | $50 Individual and $150 per Family |
Annual Benefit Maximum | $1,000 In-Network $750 Out-of-Network | $1,000 In-Network $750 Out-of-Network |
Diagnostic & Preventive Services | Plan covers 100% In-Network Plan covers 80% Out-of Network after deductible | Plan covers 100% In-Network Plan covers 80% Out-of-Network after deductible |
Basic Services | 70% In-Network 50% Out-of-Network coverage by the plan after you first pay the annual deductible |
80% In-Network 60% Out-of-Network coverage by the plan after you first pay the annual deductible |
Major Services | Not covered | 50% In-Network 40% Out-of-Network coverage by the plan after you first pay the annual deductible |
Orthodontic Services (children only) |
Not covered |
50% coverage by the plan, you pay the rest |
Orthodontia Lifetime Max | Not covered | $1,000/person |
Bi-weekly Premiums
Employee-Only Employee + Spouse Employee + Child(ren) Family |
$7.27 $13.71 $18.12 $28.27 |
$9.84 $18.54 $24.51 $38.23 |
Certificates
Summary of Benefits
In-Network Benefits | Basic Plan |
Enhanced Plan |
---|---|---|
Copay | $10 | No Copayment |
Frames | $25 Copayment; Retail frames allowance of $130 on covered frames |
No Copayment; Retail frames allowance of $200 on covered frames |
Frames Frequency | Once every 12 months | Once every 12 months |
Contact Lenses | $60 maximum copayment | $60 maximum copayment |
Bi-Weekly Premium
Employee-Only Employee + Spouse Employee + Child(ren) Family |
$3.54 $6.19 $6.31 $10.49 |
$6.00 $10/46 $10.69 $17.76 |
HSAs are savings accounts funded by pre-tax contributions from your paycheck. These accounts
earn interest tax free and can be used to help pay for a wide range of medical,
prescription, dental and vision expenses.
Unlike the funds in a flexible spending account, HSA funds are yours to keep – even if you
leave Learning Care Group!
✓ Contributions are pre-tax and are automatically deducted
✓ Funds rollover from year-to-year and are yours to keep
✓ Catch-up contributions are for those aged 55 and older
A Health Care FSA (HCFSA) is a pre-tax benefit account that's used to pay for eligible
medical, dental, and vision care expenses - those not covered by your health care plan or
elsewhere.
It's a smart, simple way to save money while keeping you and your family healthy and
protected.
✓ Use pre-tax dollars to pay for eligible expenses
✓ $2,700 contribution limit
A Dependent Care FSA (DCFSA) is a pre-tax benefit account used to pay for eligible dependent
care services, such as preschool, summer day camp, before or after school programs, and
child
or adult daycare.
It's a smart, simple way to save money while taking care of your loved ones so that you can
continue to work.
✓ Use pre-tax dollars to pay for eligible dependent care services
✓ $5,000 contribution limit
With this coverage, you can deliver peace of mind to your family in the event you an experience an unexpected accident or death.
✓ Receive coverage based on a multiple of your salary depending on your job classification
✓ Living Benefit allows you to collect 80% of your policy while you are still living, in the event you are diagnosed with a terminal illness
✓ You may be able to keep coverage if you leave the company, retire, or change the number of hours you work
✓ You may purchase additional coverage for yourself. This supplemental coverage is 100% employee-paid
If you’re suddenly unable to earn a paycheck due to illness or an accident, short-term
disability insurance through Learning Care Group can replace a portion of your income during
the
initial weeks of your disability.
The benefit is offered to both full-time and part-employees. Benefits vary to your state of
residence and employment Class.
For hourly employees, you can choose between a 13-week or a 26-week benefit duration.
✓ Receive a portion of your salary for 25 weeks
✓ Off-the-job coverage
Long-term disability insurance through Learning Care Group can provide a steady stream of income to help cover essential expenses during an extended illness or after a disabling accident.
✓ Offers additional coverage beyond your initial short-term disability coverage
MetLife
Aetna Resources For LivingSM (ARFL) is available for you and your family. It’s designed for
anyone who could use a little help managing issues and life events, big and small. Best of
all, you have confidential access to the program, which you can use at no cost to you.
You can call 1-888-238-6232 anytime: 24 hours a day, seven days a week or you can visit the site and enter Username Learning Care
Group and Password EAP. Your member website is available in English and Spanish.
With almost daily reports of security breaches and hacking incidents, it’s more important
than ever to take steps to secure your personal and financial information. Identity theft
protection provides you with comprehensive monitoring, fraud alerts, and customer care to
help protect your identity and support you with cleanup should ID theft occur.
ID Watchdog Benefit Summary →
MetLife Legal offers high quality legal help whenever you need it – from buying a home to dealing with a speeding ticket. MetLife Legal makes legal assistance affordable, accessible, and easy.
✓ Access to a network of attorneys
✓ No waiting periods, deductibles, copays, or claims forms
You work hard to provide for your family, but what if something happens to you? This year we've added the new Chubb LifeTime Benefit Term Life Plan - coverage to provide for your family's needs in the event of your death, with an additional benefit for you if you should need nursing or long-term care.
✓ Waiver of premium benefit if laid off from work
✓ Offers spouse and dependent benefits
✓ Ability to continue policy if you change employers or retire
✓ Renews after initial term without requiring medical history
Accident Insurance helps protect you against the financial burden that accident-related
costs can create. Accident Insurance from CHUBB complements other benefits, including
traditional healthcare insurance.
Coverage from CHUBB provides benefits for more than 80 accidental injuries, related
expenses, and treatments spanning multiple medical categories.
CHUBB Accident Brochure
→
Accident Policy
→
Chubb Health and Wellness Benefit Claim Form →
Life can be tough sometimes, and nobody knows what lies ahead. Critical Illness coverage provides peace of mind through financial protection in the event that you are diagnosed with a critical illness such as cancer or suffer a heart attack, stroke, or other life-threatening condition.
✓ Pays a lump sum cash benefit for covered conditions
✓ No waiting period
✓ Benefits paid directly to you
✓ Rent and Mortgage Assistance for up to 6 months
Fetching savings has never been easier!
✓ Get cash back on eligible vet bills: 90%, 70% or 50% reimbursement levels
✓ Same price for pets of all ages
✓ Use any vet, anywhere
✓ Optional wellness coverage available
DailyPay is a voluntary benefit that allows you access to your earned pay when you need it,
with additional ways to help you save.
When you sign up for DailyPay, you can access your pay on-demand. No more waiting for payday!
Introduction video →
How it works video →
New Hire brochure →
Cleo’s comprehensive platform picks up where the healthcare system leaves off. From
fertility to parenthood to return-to-work and beyond, Cleo helps you balance your roles at
home and work with guidance from trusted experts and evidence-based programs that drive
results.
Considering One
Pager →
Baby One Pager →
Baby &
Kids One Pager →
ReThink offers 24/7 virtual access to expert behavioral clinicians and evidence-based
training and support. Parents and caregivers get access to clinical best practices and
intervention strategies to help them care for children of all ages with learning, social,
behavioral, or developmental challenges.
Digital Booklet
→
ReThink Flyer →
Livongo for Diabetes is a health coaching program that enables people with diabetes to share
blood glucose records with Certified Diabetes Educators.
You’ll receive feedback in real time – within minutes if there is an emergency. And you’ll
get unlimited test strips shipped to your door at no cost to you!
Get
started
Livongo for hypertension combines personalized health insights with clinical expertise to
make it easier for you to stay healthy.
Livongo uses smart, connected devices to provide you with real-time data, personalized
insights, shareable reports, and expert coaching to help you manage your hypertension.
Get
started
Supplemental Life and Accidental Death & Personal Loss
Accident
Hospital Indemnity
Critical Illness
Universal Life
Supplemental Short-Term Disability
Legal
Transamerica
MetLife
Get immediate access to specialized professionals in counseling, social work, human services and psychology. You have access to the LifeWorks network of thousands of master’s level counselors and affiliates.
✓ Get support with financial and legal issues
✓ Receive 5 free appointments included in your Niagara benefits
✓ Enjoy hassle-free scheduling with LifeWork's easy-to-use app
LifeWorks
Compliance Notices
Privacy
Summary of Benefits and Coverage
Summary Plan Description
Medicare Part D Notice
Wrap Summary Plan Description
Wrap Plan Document