2015 Options to Meet Your Needs - Benefits - RTI Health Solutions
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Benefits Options to Meet Your Needs 2015 U.S. Benefits Options
Important Terms
Coinsurance The percentage share of eligible medical expenses that the plan pays for a
covered service.
Copayments/ Copayments (copays) and deductibles are expenses to be paid by you or
Deductibles your dependent for covered services. Deductible amounts are separate
from copays, and copays do not reduce the deductible amounts. You are
responsible for paying the copay and deductible amounts, in addition to
any coinsurance percentage. Once the deductible maximum in the schedule
has been reached, you and your family do not need to satisfy any further
deductibles for the rest of that year.
Elimination period Under the disability plans, a period of continuous disability before benefits
can begin.
Flexible Spending Tax-free money deducted from your pay and placed in accounts to be used
Account (FSA) for certain health and dependent care expenses.
Health Savings A special tax-advantaged account that allows individuals to pay for current
Account (HSA) health expenses and save for future qualified medical and retiree health
expenses on a tax-free basis. An individual must be covered by a High
Deductible Health Plan to be able to take advantage of HSAs.
High Deductible A health insurance plan that includes higher deductibles (as determined by
Health Plan the Internal Revenue Service) and lower premium costs; an individual must
have a High Deductible Health Plan to open an HSA.
Insured plan A plan where RTI pays a fixed, per-employee premium to the insurance
carrier, and the insurance carrier assumes the cost of health care claims.
Maximum The allowable charge for out-of-network services, providers, and supplies.
reimbursable charge This method is indexed off Medicare's fee schedule rather than using the
(MRC) usual, customary, and reasonable (UCR) payment method.
Out-of-pocket cost The amount paid by the employee for medical expenses not covered by the
plan.
Out-of-pocket The maximum employee liability for the cost of services within the plan.
maximum
Preferred provider A traditional insurance plan with deductibles and coinsurance features. You
organization (PPO) may choose any licensed providers for your medical care, and benefits are
not restricted to any service area.
Premium The portion of the fixed cost that the employee pays, usually monthly,
through payroll deduction.
Self-insured plan A plan where RTI finances health care costs by paying claims from its own
employer funds.
Usual, customary, The fee charged by most providers in a given geographical area for a
and reasonable (UCR) particular service.
Please see your summary plan descriptions for more detailed definitions.
2015 Benefits Booklet iThe information in this booklet has been prepared as a descriptive summary of benefits
provided by RTI. In the event of any discrepancy or disagreement regarding benefits, the
provisions in the summary plan descriptions or plan documents will prevail. RTI reserves the
right to modify or terminate these plans at any time.
ii 2015 Benefits BookletContents
Introduction: 2015 Benefits Program .....................................................................................................................1
Eligibility for Benefits Coverage..................................................................................................................................... 1
Paying for Your Benefits Plans........................................................................................................................................ 1
Enrollment Tips ............................................................................................................................................................... 2
Medical Plans............................................................................................................................................................4
Eligibility............................................................................................................................................................................ 4
Four Options for Coverage............................................................................................................................................. 5
Medical Benefits Summary............................................................................................................................................. 5
Special Rules for the High Deductible Health Plan/HSA .......................................................................................... 5
Mental Health and Substance Abuse Coverage............................................................................................................ 8
ID Cards............................................................................................................................................................................. 8
Vision Plan................................................................................................................................................................8
Vision Benefits Summary................................................................................................................................................ 8
Special Rules...................................................................................................................................................................... 8
ID Cards............................................................................................................................................................................. 9
Dental Plan..............................................................................................................................................................10
Eligibility.......................................................................................................................................................................... 10
Four Options for Coverage........................................................................................................................................... 10
Dental Benefits Summary.............................................................................................................................................. 10
ID Cards........................................................................................................................................................................... 13
Flexible Spending Accounts...................................................................................................................................13
Flexible Spending Accounts Benefits Summary......................................................................................................... 13
Tax Advantages............................................................................................................................................................... 14
Special Rules ................................................................................................................................................................... 14
Health Care Flexible Spending Account .................................................................................................................... 15
Dependent Care Flexible Spending Account.............................................................................................................. 16
Group Term Life/AD&D Insurance.......................................................................................................................18
Basic Term Life/AD&D Insurance............................................................................................................................... 18
Supplemental Term Life/AD&D Insurance and Dependent Life Insurance.......................................................... 18
Insurability ..................................................................................................................................................................... 19
Naming a Beneficiary..................................................................................................................................................... 20
Short-Term Disability Insurance...........................................................................................................................20
Eligibility.......................................................................................................................................................................... 20
Insurability...................................................................................................................................................................... 20
Coverage.......................................................................................................................................................................... 20
Long-Term Disability Insurance............................................................................................................................21
Eligibility.......................................................................................................................................................................... 21
Insurability...................................................................................................................................................................... 21
Coverage.......................................................................................................................................................................... 21
Maximum Benefit........................................................................................................................................................... 22
Supplemental (Buy-Up) Individual Long-Term Disability Insurance..................................................................... 22
Retirement...............................................................................................................................................................22
RTI 401(k) Retirement Plan.......................................................................................................................................... 22
RTI Retiree Health Care Program................................................................................................................................ 23
Making Changes During the Year..........................................................................................................................24
Making Changes to Your Benefits................................................................................................................................ 24
Life Status Changes........................................................................................................................................................ 24
2015 Benefits Booklet iiiOther Benefits Information...................................................................................................................................26 Holidays........................................................................................................................................................................... 26 Paid Time Off.................................................................................................................................................................. 26 Direct Payroll Deposit .................................................................................................................................................. 27 Adoption Assistance Reimbursement Program......................................................................................................... 27 Educational Assistance Program ................................................................................................................................. 27 Fitness and Nutrition Benefit—Rival Fusion.............................................................................................................. 27 Employee Assistance Program...................................................................................................................................... 27 Bereavement Leave......................................................................................................................................................... 28 Long-Term Care Insurance........................................................................................................................................... 28 Merit Scholarships.......................................................................................................................................................... 28 Military Leave................................................................................................................................................................. 28 Professional Development Awards............................................................................................................................... 29 Relocation Expenses...................................................................................................................................................... 29 Travel and Accident Insurance .................................................................................................................................... 29 Childcare Tuition Subsidy............................................................................................................................................. 29 COBRA....................................................................................................................................................................30 Employee......................................................................................................................................................................... 30 Dependents..................................................................................................................................................................... 30 Other Reasons for End of Continuation Coverage ................................................................................................... 31 Benefits Directory...................................................................................................................................................32 Tables 1. Benefits Eligibility.....................................................................................................................................................................1 2. Medical Plan Coverage Options..............................................................................................................................................5 3. CIGNA Medical Plans Comparison........................................................................................................................................6 4. RTI Contributions to the High Deductible Health Plan/HSA...............................................................................................7 5. VSP Benefits Summary.............................................................................................................................................................9 6. Dental Plan Coverage Options...............................................................................................................................................10 7. Dental Rewards Program.......................................................................................................................................................12 8. Supplemental Term Life/AD&D and Dependent Life Insurance Coverage........................................................................18 9. Schedule of Benefits for Long-Term Disability.....................................................................................................................22 10. RTI Vesting Schedule............................................................................................................................................................23 11. 2015 IRS Annual Contribution Limits for 401(k) Tax-Deferred Accounts......................................................................23 12. Retiree Health Care Program Eligibility Requirements and Premium Credits................................................................24 13. IRS-Approved Benefit Changes...........................................................................................................................................25 14. PTO Accrual Rates................................................................................................................................................................27 15. Childcare Tuition Subsidy Rates..........................................................................................................................................29 iv 2015 Benefits Booklet
Introduction: 2015 Paying for Your Benefits Plans
Benefits Program Generally, you and RTI share the cost for your
benefits plans. You pay for some of your benefits
RTI International offers a comprehensive
with pre-tax dollars and others with post-tax
benefits package through our benefits program.
dollars.
In this booklet, you will find details about the
benefits that are available to our U.S.-based staff At Hire
and their eligible dependents. We encourage you Following are the benefits plans available on
to use this booklet to help you consider your your date of hire and a summary of how you pay
benefit options for 2015 and choose those that for them:
work best for you and your family. For detailed
plan information and other resources, please Medical Insurance
visit StaffNet at http://staffnet.rti.org/services/ • You and RTI share the cost for coverage.
benefits/domestic.cfm. • Your share of the cost of insurance (the
premiums) is paid with pre-tax dollars.
Eligibility for Benefits Dental Insurance
Coverage • You and RTI share the cost for coverage.
To be eligible for benefits coverage, you must be
• Your share of the premiums is paid with
a regular full-time or part-time employee. Your
pre-tax dollars.
employment status affects your eligibility for
some of these benefits. See Table 1 to determine Flexible Spending Accounts
your general eligibility for benefits coverage. • You can choose to contribute to a health care
FSA, a dependent care FSA, or both.
Table 1. Benefits Eligibility
• Your contributions are made with pre-tax
For the following benefits … You must be
scheduled to work dollars.
at least … Group Term Life and AD&D Insurance
Medical insurance 25% time • RTI provides basic term life and AD&D
Dental insurance 25% time insurance (1 times your annual base salary at
Flexible Spending 25% time no premium cost to you).
Accounts (FSAs) • In addition to the basic term life/AD&D
Group term life/ 50% time insurance coverage RTI provides, you can
accidental death and
purchase supplemental term life/AD&D
dismemberment
(AD&D) insurance insurance with post-tax dollars. You pay the
full cost of coverage. You can purchase an
Short-term disability 37.5% time
(STD) insurance additional1
Long-term disability 37.5% time –– 1 times annual salary (total 2 times)
(LTD) insurance –– 2 times annual salary (total 3 times)
–– 3 times annual salary (total 4 times).
1
If you enroll yourself and your dependents within 30 days of hire or date first eligible for coverage, no medical
evidence of insurability, known as a Statement of Health, is required for coverage amounts up to $500,000 for you,
$30,000 for your spouse/domestic partner, or $10,000 for your dependent children. Larger coverage amounts will
require a Statement of Health, regardless of when you enroll.
2015 Benefits Booklet 1Dependent Life Insurance
What If I Don’t Enroll When First Hired?
• You can purchase life insurance for your
eligible dependents.1 If you do not enroll within 30 days of
your hire date or date first eligible for
• Your premiums are paid with post-tax coverage, you will have no coverage
dollars. except for group term life/AD&D
Short-Term Disability Insurance insurance. Your next opportunity to
enroll in benefits will occur at the next
• You and RTI share the cost for coverage. scheduled open enrollment period. If
• Your share of the premiums is paid with you are scheduled to work 50% time or
post-tax dollars. more, RTI automatically provides group
term life/AD&D coverage at 1 times
Long-Term Disability Insurance your base annual salary at no cost to
• You and RTI share the cost for coverage. you.
• Your share of the premiums is paid with If you do not enroll when first eligible,
post-tax dollars. you cannot enroll in medical/vision
coverage, dental coverage, or FSAs
401(k) Retirement Plan during the year unless you or your
• You can elect to contribute pre-tax or after- family member has a life status change.
tax earnings, beginning on your date of hire. Examples of life status changes include
birth, marriage, divorce, and other
After 1 Year of Service qualifying events that affect your and
and Age 19 your family members’ eligibility for
When you complete 1 year of service and are at group insurance benefits. You will have
to wait until the next open enrollment
least 19 years old, RTI will contribute an amount
period to enroll in medical/vision
equal to 8% of your base salary into your 401(k) coverage, dental coverage, and FSAs for
plan every pay period. (See the Retirement the following year.
section of this booklet for details.) You may elect life/AD&D and disability
coverage any time during the year.
Enrollment Tips However, you must submit a Statement
of Health form if you do not enroll
Enrolling in Benefits
within your first 30 days of your hire
Each year, you have an opportunity to make new date or date first eligible for coverage.
benefit elections during the open enrollment Any request to enroll for the first time
period. Once you make your elections, they will or to increase coverage made 30 days
remain in effect until the end of the calendar after your first eligibility will require
year (January 1 to December 31). completion of a Statement of Health
form and approval by the carrier before
You don’t have to enroll the same family changes to your coverage will be made.
members for each plan (e.g., you may enroll
your entire family in medical/vision coverage
and enroll only yourself in dental coverage).
How you enroll in your benefits is entirely up to
you.
2 2015 Benefits BookletIf you are a full- or part-time employee and • Eligibility for children will end on the date
(1) waive medical/vision coverage for yourself they turn 26.
and (2) are not covered as a dependent under NOTE: Children of domestic partners are not
any RTI medical/vision plans, you will be eligible for medical/vision or dental insurance
eligible to receive a monthly credit in your coverage.
paycheck.
Spousal Verification
• Full-time employees will receive a $60
monthly credit for waiving coverage. During open enrollment, as part of the online
enrollment process, we ask all participants
• Part-time employees will receive a $30
enrolling a spouse for the first time under RTI’s
monthly credit for waiving coverage.
benefit plans (whether the spouse is of the same
• The monthly credit you receive is a taxable sex or opposite sex) to verify that the individual
benefit. is the participant’s lawful spouse. For this
If you and your spouse/domestic partner purpose, a spouse is defined as an individual
both work for RTI, you cannot have “double who is legally recognized as the spouse of a
coverage.” In other words, you cannot be participant under the laws of the state or foreign
covered under the dependent life insurance jurisdiction in which the marriage took place
of another RTI employee if you are both and under the Internal Revenue Service (IRS)
working for RTI. You also cannot cover the Code. The term “spouse” includes a domestic
same dependent children under each of your partner if the domestic partner is legally
dependent life plans if you and your spouse/ recognized as the spouse of the participant as
domestic partner are both RTI employees. described in the previous sentence.
Coverage for Children Up to Age 26 If you are enrolling a spouse and you verify
For medical/vision, dental, and life insurance during your online enrollment that you
coverage, eligible children are defined as follows: are legally married to that spouse, the pre-
tax treatment to your benefit elections will
• Eligible children up to age 26 include automatically apply. Complete instructions on
–– Your biological son, biological daughter, spousal verification can be found on StaffNet at
stepson, or stepdaughter http://staffnet.rti.org/services/benefits/domestic.
–– Your legally adopted child or a child who cfm.
has been legally placed for adoption and If you choose to cover a domestic partner who
legally placed foster children does not meet the prior definition of a spouse,
–– A child who is placed with you by an you will be taxed on the value of the domestic
authorized placement agency or by a partner coverage less the premium you pay
judgment decree or court order toward the cost of domestic partner coverage.
–– A child for whom you are the legal The portion of the premium you pay for
guardian. domestic partner coverage is paid on a post-
tax basis. Special tax and legal considerations
• Eligible children up to age 26 do not need
apply when covering a domestic partner. If you
to be your tax dependents (no residency or
have any questions, please consult a tax or legal
support requirements apply).
advisor before enrollment.
• Eligible children up to age 26 can be married.
However, you may not cover their spouses,
partners, or children.
2015 Benefits Booklet 3Spouse/Domestic Partner Medical Plans
Surcharge As an employee, one of the most important
If you enroll a spouse/domestic partner as a decisions you must make is choosing the
dependent under one of RTI’s medical plans, medical plan option that is best for you and
you must access GEMS Self Service at http:// your family. RTI offers three CIGNA medical
staffnet.rti.org/gems/ and certify your spouse’s/ plans to all U.S.-based employees, except
domestic partner’s “other employer’s coverage” those living in Hawaii. Employees living in
status. If your spouse/domestic partner is Hawaii are eligible for the health plan offered
eligible for another employer’s health plan, you through Hawaii Medical Service Association
may enroll him or her in RTI’s plan; however, (HMSA) only. Employees living in California
a $100 per month spousal surcharge will apply. are eligible for a traditional Kaiser Permanente
The certification process can be completed or health maintenance organization (HMO) plan
updated any time throughout the year, if there is in addition to the three CIGNA health plans.
a change in the other employer’s coverage status. Employees living in Massachusetts are eligible
Any employee who enrolls a spouse/domestic for two Tufts health plans in addition to the
partner and does not complete the spouse/ three CIGNA health plans. Check the Health
domestic partner certification process will incur Insurance section of the Benefits page on
a surcharge. If you enroll a domestic partner for StaffNet for HMSA, Kaiser, and Tufts health
the first time, you will be required to complete plan information.
an affidavit of domestic partnership within 30
days of that enrollment. RTI’s medical plans offer a variety of coverage
options to meet your needs. This coverage can
Please follow these steps to certify your spouse/ protect you and your family from high and often
domestic partner: unexpected medical expenses.
• Step 1: Log into GEMS and select Main
Menu>Self Service>Benefits>Dependent Eligibility
Info. On this screen, you will see All regular employees scheduled to work 25%
information about your dependents and the time or more are eligible for medical coverage
Spousal Verification and Other Coverage beginning on the first day of employment. You
Certification link. may also enroll eligible dependents, who include
• Step 2: Select the Spousal Verification your
and Other Coverage Certification link • Spouse
to certify whether your spouse/domestic
• Domestic partner (opposite or same sex;
partner is eligible for coverage under another
in accordance with applicable state laws,
employer’s health plan. Once you have
registration may be required)
indicated the correct eligibility statement,
select OK. • Children up to age 26.
See the Coverage for Children Up to Age 26
Dental Lock-In section for the definition of eligible dependents
A 2-year lock-in applies for the dental Premier
and enrollment requirements.
Plan. If you elect the Premier Plan, you must
remain enrolled in this plan for 2 years. For NOTE: Dependents of domestic partners
example, if you enroll in this coverage for 2015, are not eligible for medical/vision or dental
you must remain enrolled through the end of insurance coverage.
2016.
4 2015 Benefits BookletFour Options for Coverage You minimize your costs when you use hospitals
and doctors in the Open Access Plus network.
As shown in Table 2, there are four ways to
You can select a primary care physician
cover yourself and your eligible dependents.
(although this is not required) to coordinate
Table 2. Medical Plan Coverage Options your care. No referrals are required to access
Options Who Is Covered services from network specialists.
Individual Covers employee only You can seek care outside the network, but keep
Employee/ Covers employee and in mind that you will pay higher out-of-pocket
spouse spouse/domestic partner
costs when you use out-of-network providers.
Employee/ Covers employee and all
children dependent children Table 3 compares the benefits among the three
Family Covers employee, spouse/ CIGNA medical plans. The table is intended
domestic partner, and only to highlight your benefits and should not
employee’s dependent be relied on to fully determine coverage.
children NOTE: The benefit summary information
provided here does not cover all of your health
Medical Benefits Summary care expenses. For more details about the
Through CIGNA, RTI offers the following three medical plans and their terms, see the plan
medical plan options: descriptions on StaffNet at http://staffnet.rti.
• Premier Plan—with a $400 individual/$800 org/services/benefits/domestic.cfm.
family annual deductible for in-network
coverage Special Rules for the High
• Standard Plan—with a $600
Deductible Health Plan/HSA
individual/$1,200 family annual deductible If you enroll in the High Deductible Health
for in-network coverage Plan/HSA, you must open a JPMorgan
Chase bank account to receive RTI employer
• High Deductible Health Plan/Health
contributions. If you do not open a bank
Savings Account (HSA)—with a $1,300
account by December 1, 2015, you will forfeit
individual/$2,600 family annual deductible
all RTI employer contributions that would
for in-network coverage paired with an HSA.
have gone into your account, and your own
(For this plan, deductibles are determined by
contributions will be returned to you as taxable
IRS and are subject to change each year.)
income.
The three medical plans are centered around the
Open Access Plus network—a group of doctors, The maximum annual contribution amount
hospitals, and other health care providers. When for 2015 is $3,350 for employee-only coverage
you need medical care, you can decide to either and $6,650 for family coverage, which includes
use the providers in the network or seek services RTI employer contributions. Individuals who
from a provider outside the network. You always are 55 or older may make a special catch-up
have a choice. contribution of $1,000. If you contribute the
annual maximum contribution amount, you
must remain enrolled in the High Deductible
To enroll in medical insurance, you must Health Plan/HSA through December 31, 2016,
be scheduled to work 25% time or more. to avoid paying income tax and a 10% penalty
on the amount in the account.
2015 Benefits Booklet 5Table 3. CIGNA Medical Plans Comparison
CIGNA Open Access Premier CIGNA Open Access Standard High Deductible Health Plan/HSA
In Network Out of Network In Network Out of Network In Network Out of Network
6
Deductible
Individual $400 $1,600 $600 $1,800 $1,300 $2,400
Family $800 $4,800 $1,200 $3,400 $2,600 $7,200
Out-of-Pocket Maximum
Individual $3,500 $9,000 $4,500 $12,000 $6,350 $12,000
Family $7,000 $18,000 $9,000 $24,000 $12,700 $24,000
Office Visit Copays
Preventive care 100% (no copay) N/A 100% (no copay) N/A 100% (no copay) 100%
2015 Benefits Booklet
Primary care physician $25 70%/30%* $30 60%/40%* 80%/20%* 60%/40%*
Specialist $40 70%/30%* $55 60%/40%* 80%/20%* 60%/40%*
Coinsurance (Plan portion/your portion)
Lifetime Maximum Benefit: Unlimited
MRI, CT/PET scans $75 copay, then $75 copay, then $100 copay, then $100 copay, then 80%/20%* 60%/40%*
90%/10%* 70%/30%* 80%/20%* 60%/40%*
Hospital–lnpatient 90%/10%* 70%/30%* 80%/20%* 60%/40%* 80%/20%* 60%/40%*
Hospital–Outpatient 90%/10%* 70%/30%* 80%/20%* 60%/40%* 80%/20%* 60%/40%*
Emergency room $155 copay $155 copay (for true $175 copay $175 copay (for true 80%/20%* 80%/20%* (for true
emergency only; emergency only; emergency only;
otherwise, 70%/30%*) otherwise, 60%/40%*) otherwise, 60%/40%*)
Mental Health and Substance Abuse (MH/SA) Combined
MH/SA–lnpatient 90%/10%* 70%/30%* 80%/20%* 60%/40%* 80%/20%* 60%/40%*
MH/SA–Outpatient $25 copay 70%/30%* $30 copay 60%/40%* 80%/20%* 60%/40%*
Retail Pharmacy (30-day supply)
Generic $10 No coverage $10 No coverage 80%/20%* 50%/50%*
Preferred brand $35 No coverage $50 No coverage 70%/30%* 50%/50%*
Nonpreferred brand $70 No coverage $100 No coverage 60%/40%* 50%/50%*
Deductible $25 (individual)** N/A $50 (individual)** N/A Plan deductible Plan deductible
$50 (family)** $100 (family)**
Mail-Order Pharmacy (90-day supply)
Generic $20 No coverage $20 No coverage 80%/20%* No coverage
Preferred brand $70 No coverage $80 No coverage 70%/30%* No coverage
Nonpreferred brand $140 No coverage $160 No coverage 60%/40%* No coverage
Deductible N/A N/A N/A N/A N/A N/A
* After the plan deductible is met, you and the plan share the cost of services. The first number is the percentage of coinsurance paid by the plan,
and the second number is the percentage you pay.
** Deductible is waived for purchase of generic drugs.Table 4 shows the amounts that RTI will Those enrolled in the High Deductible Health
contribute to the High Deductible Health Plan/ Plan/HSA can save out-of-pocket costs for
HSA: certain prescriptions. Preventive medications
used to treat chronic diseases will be covered
Table 4. RTI Contributions to the High Deductible
Health Plan/HSA at 100% and will not be subject to your annual
deductible. Preventive medications are found
For coverage for… RTI contributions:
on the Preventive Drug List located on CIGNA’s
Employee only $500 per year ($41.67 per
month) website at www.mycigna.com. Any drugs you
Employee plus spouse/ $750 per year ($62.50 per purchase that are not on the list will be subject
domestic partner month) to the annual deductible before the plan pays.
Employee plus children $750 per year ($62.50 per
month)
Family $1,000 per year ($83.33 per
month)
Important Facts to Remember
• If you are enrolled in any of the CIGNA or Kaiser medical plans, your basic vision coverage is offered
through VSP and not through CIGNA. See the next section of this booklet for more information
about our vision plan.
• If you are enrolled in any of the CIGNA medical plans, your mental health and substance abuse
coverage is offered through CIGNA Behavioral Health. You must obtain prior authorization for
inpatient mental health and substance abuse benefits by calling 1.800.926.2273. You can identify
CIGNA providers at www.cignabehavioral.com.
• Employees in Massachusetts and Rhode Island may choose from the CIGNA preferred provider
organization (PPO) medical plans, which are offered through the CareLink-Tufts network, in
addition to the PPO plans offered directly by Tufts.
• If you choose not to be covered by RTI’s medical insurance because you have coverage elsewhere,
you may not join or rejoin until the following calendar year unless you experience a qualified life
status change, as described in the Making Changes During the Year section.
• If you don’t enroll your dependents when they are first eligible to be enrolled, you can’t enroll
them until the next open enrollment period unless you experience a qualified life status change, as
described in the Making Changes During the Year section.
• For those dependents covered by both your and your spouse’s/domestic partner’s insurance, most
insurance carriers will consider the policy belonging to the parent whose birthday occurs earlier in
the calendar year to be the primary policy.
• If you and your spouse/domestic partner have other coverage, the RTI medical plan as either the
primary or secondary payor will pay only up to the RTI plan maximum percentage. Benefits will not
be coordinated between the insurance companies to pay 100% of medical costs.
• Contact Human Resources on StaffNet at My Service Portal if you have questions about your
benefits coverage. You can also call 919.541.1200 or 1.800.334.8571, ext. 21200. The address for
Human Resources is:
RTI International
Human Resources Help Desk
3040 East Cornwallis Road, Building O9
Research Triangle Park, NC 27709
2015 Benefits Booklet 7Mental Health and Substance Vision Benefits Summary
Abuse Coverage To use your vision benefits, simply make an
Mental health and substance abuse benefits for appointment with a VSP provider and tell the
CIGNA members are provided through CIGNA provider you are a VSP member. You will not
Behavioral Health (www.cignabehavioral. have to show an ID card, fill out claim forms, or
com), which provides inpatient and outpatient wait for reimbursement. You can search for a list
services. Prior authorization for inpatient of providers at www.vsp.com.
mental health and substance abuse benefits is Table 5 shows a summary of the VSP benefits
required; call 1.800.926.2273 to obtain prior for both in-network and out-of-network
authorization. Prior authorization for routine providers.
outpatient care, such as individual and group
counseling, is not required. Special Rules
The following expenses are not covered by the
ID Cards vision plan:
CIGNA will mail ID cards for you and each of
your enrolled family members. Each enrolled • More than one eye exam in any 12-month
family member needs to use his or her own period
card. • More than one pair of lenses in any
12-month period
You can receive up to four ID cards per package
from CIGNA. If you enroll more than four • More than one set of frames in any 24-month
family members, you will receive an additional period
package from CIGNA with extra ID cards. • More than $210 for contact lenses in any
12-month period.
Vision Plan When chosen, the contact lenses benefit will
be in lieu of any other lenses benefit during
(applies to employees enrolled in the
the 12-month period and in lieu of any other
CIGNA or Kaiser medical plans) frame benefit during the 24-month period.
If you choose any of the CIGNA or Kaiser When lenses for glasses are chosen, expenses for
medical plans, you and any covered dependents contact lenses are not covered expenses during
are also automatically provided vision coverage the 12-month period.
through VSP. VSP is our vision carrier, and
Ameritas is our vision plan administrator.
Contact VSP Member Services at 1.800.877.7195
if you have any questions about your vision
coverage.
8 2015 Benefits BookletID Cards
ID cards are not required to use your VSP Vision Plan Highlights
benefits. However, Ameritas will send you • Approximately 30,000 providers
two VSP ID cards if you are a new enrollee or • One-stop shopping: exams, frames,
make changes to your plan. To order new or and lenses, plus discounts for
additional vision cards, contact Ameritas at additional services
1.800.487.5553. • Personalized self-service on the web
• Laser VisionCare Program
–– Educational information on the web
–– Personalized evaluation from
your doctor
–– Surgical care from credentialed
laser centers
–– Up to 20% discount on LASIK and PRK
laser vision correction procedures
Table 5. VSP Benefits Summary
Benefits In Network Out of Network
Annual exams $10 Up to $45
Materials deductible $25 $25
for lenses and/or
frames
VSP pays: VSP pays:
Frame $120 allowance toward any frame of your choice Up to $70
plus 20% off any amount over the allowance
Single lenses 100% Up to $30 per pair
Bifocal lenses 100% Up to $50 per pair
Trifocal lenses 100% Up to $75 per pair
Lenticular lenses 100% Up to $100 per pair
Contact lenses— 100% Up to $210
necessary
Contact lenses— $105 allowance toward the contact lens exam and Up to $105
elective contact lenses plus a 15% discount off the contact
lens exam before the allowance
You receive:
Frequency Exam every 12 months; lenses every 12 months; frames every 24
months—based on the date of receipt for services or materials
NOTE: Lenses or contacts may be covered at the highest level in this table, but not both. There are additional
charges for special features added to lenses (e.g., compounded, progressive).
2015 Benefits Booklet 9Dental Plan
To enroll in dental insurance, you must be
RTI’s benefits program offers a range of dental
scheduled to work 25% time or more.
benefits for you and your dependents. We
have two dental plan options that provide
comprehensive benefits: the Premier Plan and
the Standard Plan. Four Options for Coverage
The Premier Plan provides a higher level of As shown in Table 6, there are four ways to
coverage with a higher premium cost than the cover yourself and your eligible dependents in
Standard Plan. Both plans are PPOs and offer dental coverage.
a network of dentists through Ameritas. With
Table 6. Dental Plan Coverage Options
both plans, you may visit any licensed dentist,
Options Who Is Covered
whether the dentist is considered in-network or
out-of-network. However, you may want to use Individual Covers employee only
participating network dentists for lower out-of- Employee/ Covers employee and
spouse spouse/domestic partner
pocket costs.
Employee/ Covers employee and all
children dependent children
Eligibility
Family Covers employee, spouse/
All regular employees scheduled to work 25% domestic partner, and
time or more are eligible for dental coverage employee’s dependent
beginning on the first day of employment. You children
may also enroll your eligible dependents, who
include your Dental Benefits Summary
• Spouse Premier Plan
• Domestic partner (opposite or same sex; The Premier Plan pays
in accordance with applicable state laws, • 100% of the usual, customary, and reasonable
registration may be required) (UCR) charges for diagnostic/preventive
• Children up to age 26. services (not subject to the deductible)
See the Coverage for Children Up to Age 26 • 90% of the UCR charges for maintenance,
section for the definition of eligible dependents oral surgery, and periodontic services
and enrollment requirements. • 60% of the UCR charges for prosthetic/
NOTE: Dependents of domestic partners complex restorative services and implants
are not eligible for medical/vision or dental • Up to $2,000 after a $50 per-member
insurance coverage. deductible is met each calendar year (no
more than 3 times the individual deductible
must be satisfied in each benefit period per
family)
• Up to $2,000 lifetime maximum orthodontia
benefit per covered child up to age 19.
10 2015 Benefits BookletStandard Plan Dental Rewards
The Standard Plan pays Ameritas offers a Dental Rewards program
for both the Premier and Standard plans. This
• 100% of the UCR charges for diagnostic/
program encourages good dental habits through
preventive services (not subject to the
regular dental checkups. If you file at least one
deductible)
claim during the year and benefits paid are
• 80% of the UCR charges for maintenance, less than $750 for the year, you will qualify
oral surgery, and periodontic services for a reward of a $250 increase in your annual
• 50% of the UCR charges for prosthetic/ maximum the following calendar year. This
complex restorative services increase continues until you reach a total reward
of $1,000. The Dental Rewards amount earned is
• Up to $1,500 after a $50 per-member
reduced by any amount used in any year. Dental
deductible is met each calendar year (no
Rewards applies to each person who is enrolled
more than 3 times the individual deductible
in coverage, including any of your covered
must be satisfied in each benefit period per
family members.
family)
• Up to $1,000 lifetime maximum orthodontia
benefit per covered child up to age 19.
NOTE: If you elect the Premier Plan, you
must remain enrolled in this plan for 2 years.
For example, if you enroll in this coverage for
2015, you must remain enrolled through the
end of 2016.
Important Facts to Remember
• If you choose not to be covered by RTI’s dental insurance because you have coverage
elsewhere, you may not join or rejoin until the following calendar year unless you
experience a qualified life status change, as described in the Making Changes During the
Year section of this booklet.
• If you don’t enroll your dependents when they are first eligible to be enrolled, you can’t
enroll them until the next open enrollment unless you experience a qualified life status
change, as described in the Making Changes During the Year section.
• When making your decision about coverage for your dependent children, keep in mind
the insurance industry’s birthday rule. If your dependents are covered by both your
insurance and your spouse’s/domestic partner’s insurance, most carriers will consider the
policy belonging to the parent whose birthday occurs earlier in the calendar year to be
the primary policy.
• If you and your spouse/domestic partner have other coverage, the RTI dental plan
as either the primary or secondary payor will pay only up to the RTI plan maximum
percentage. Benefits will not be coordinated between the insurance companies to pay
100% of dental costs.
2015 Benefits Booklet 11The program has a cap of $1,000 on the total • X-rays (full series of X-rays every 3 years;
rewards you can earn. If you use the entire bitewing twice per calendar year)
$1,000 in rewards, you can earn rewards during • Prophylaxis/fluoride application to prevent
the next year. Ameritas will use your annual decay (twice per calendar year, with fluoride
dental maximum benefit first and then use application limited to dependents under
any available funds from your Dental Rewards age 19)
balance. All deductibles and coinsurance
• Sealants for first and second molars for
limitations still apply. See Table 7 for a summary
members age 5 through 15
of the Dental Rewards benefits.
• Space maintainers (limited to dependents
Table 7. Dental Rewards Program under age 19).
Benefit $750 The annual Maintenance, Oral Surgery, and
amount maximum amount
for your dental Periodontic Services
benefits (paid at 90% of UCR under the Premier Plan and
Annual $250 The amount you 80% of UCR under the Standard Plan)
carryover can carry over to Your dental benefits cover many maintenance
amount the following year’s procedures, including the following:
annual maximum
Annual $150 The additional bonus • Palliative emergency treatment and
PPO bonus you earn during emergency oral examination, not including
the year if you see a permanent restorations or services
network dentist
• Biopsies of oral tissue
Maximum $1,000 The maximum you
carryover can accumulate and • Routine fillings to restore diseased teeth
carry over • Repair of removable dentures
Covered Services • Re-cementing of inlays, crowns, and bridges
The following benefits are based on UCR • Stainless steel crowns.
charges for your geographic area. We strongly Surgical procedures covered by your dental
encourage you to contact Ameritas for benefits include the following:
preauthorization of dental services totaling
more than $300. • Simple extractions
• Hemisection and apicoectomy
Diagnostic and Preventive Services
• Oral surgery, including surgical removal of
(paid at 100% of UCR under the Premier and
teeth and maxillary or mandibular intrabony
Standard plans)
cysts and procedures performed to prepare
Because many dental expenses result from the mouth for dentures
problems that could have been prevented by
• General anesthesia administered in
regular checkups, all diagnostic and preventive
connection with a covered dental service,
services are paid without a deductible. This part
only if administered by an individual
of the program helps you avoid such expenses
licensed to administer general anesthesia.
by paying for preventive treatment. Diagnostic
and preventive services include the following:
• Routine examinations, teeth cleaning, and
scaling (two per calendar year)
12 2015 Benefits BookletYou can receive benefits for treatment of
disease of the gum and tissues around the teeth, To enroll in FSAs, you must be scheduled
including the following: to work 25% time or more.
• Gingival curettage
• Gingivectomy and gingivoplasty Flexible Spending
• Osseous surgery Accounts
• Periodontal scaling and root planing.
FSAs are an important feature of the benefits
Prosthetic and Complex Restorative program. An FSA allows you to set aside a
Services certain amount of your paycheck into an
(paid at 60% of UCR under the Premier Plan and account before it is taxed. You can then pay
50% of UCR under the Standard Plan) yourself back, on a tax-free basis, for eligible
Your dentist may use an artificial device to expenses.
restore your natural teeth. In this case, your When you begin employment or during the
dental program covers the following: open enrollment period, you can choose to set
up a health care FSA, a dependent care FSA, or
• Inlays and onlays (not part of bridge)
both. Flores & Associates is the administrator of
• Crowns (not part of bridge)—one per tooth
the FSA plan.
every 5 years (must be older than age 16)
• Denture adjustments and relining within 6 Flexible Spending Accounts
months of initial denture placement Benefits Summary
• Full and partial dentures and fixed bridges There are two types of FSAs:
(once every 5 years)
• Health care FSA: for reimbursement of
• Fixed bridge repairs
out-of-pocket health care expenses such
• Dental implants (covered under the Premier
as copays, deductibles, coinsurance, dental
Plan only).
expenses, and vision expenses for yourself
Orthodontia Services and qualified dependents.
(paid at 50% of UCR under the Premier and • Dependent care FSA: for reimbursement of
Standard plans) dependent care expenses such as nursery
Orthodontia services are payable at 50% of UCR care, after-school programs, and elder care.
for covered expenses. The plan has a lifetime You may contribute up to $2,550 (or a
maximum of $2,000 for orthodontia services maximum of $212.50 per month) in a health
under the Premier Plan and $1,000 under the care FSA in calendar year 2015. You may
Standard Plan for members up to age 19. contribute up to $5,000 (or a maximum of
$416.66 per month) in a dependent care FSA.
ID Cards
A per-pay-period contribution is automatically
Ameritas will send you two VSP ID cards if
calculated and deducted from your paycheck
you are a new enrollee or make changes to your
throughout the year. The contributions are
dental plan. To order new or additional cards,
credited to your account after each paycheck.
contact Ameritas at 1.800.487.5553.
You can then get reimbursed with pre-tax
dollars in your spending account.
2015 Benefits Booklet 13Tax Advantages “Use It or Lose It” Rule
You do not pay federal or state income taxes on Any amounts that remain unused in your
your FSA contributions. If your earnings are health care or dependent care FSAs at the end
below the maximum amount taxed for Social of the year are forfeited. As stated under the
Security purposes each year, then having money “separate accounts” rule, you may not transfer
for the FSA deducted from your paycheck pre- unused funds from one account to another. (An
tax will also reduce your Social Security (Federal exception to this rule is described in the next
Insurance Contributions Act [FICA]) taxes. section.)
Because your benefits from Social Security are To reduce the risk of forfeiture, carefully
based on the FICA taxes that you and RTI pay, calculate your expenses before you make your
your ultimate Social Security benefit could elections.
be slightly smaller than if you choose not to
participate in the FSA. $500 Health Care FSA Carryover
Reducing your salary for health care or
Provision
IRS modified the “use it or lose it” rule for
dependent care expenses does not affect the
health care FSAs to permit a limited carryover
value of your salary-based RTI benefits. Life
of up to $500 of unspent funds from one plan
insurance coverage, disability benefits, and
year to the next. RTI adopted this provision. If
retirement plan contributions will continue to
you have a balance of up to $500 in your health
be based on your gross salary.
care FSA at the end of the year, the funds will
be carried over automatically. If you have more
Special Rules
than $500 in your account at the end of the year,
“Separate Accounts” Rule we will carry over up to $500 and you will lose
You must make separate contribution elections the rest.
for health care and dependent care FSAs.
If you elect both, separate accounts will be Deadline for Claims
created—one for health care expenses and Expenses for the health care and dependent
one for dependent care expenses—and the care FSAs must be incurred by December 31
contributions may not be commingled. In other of each year. To receive reimbursement, you
words, you may not move excess (unused) must submit claims for both accounts by March
dollars from one account to another. Each 31 of the following year. (See the $500 Health
account has its own “use it or lose it” rule Care FSA Carryover Provision section for an
(described in the next paragraph). The plans exception.)
operate on a calendar-year basis, so each If you leave RTI, you may continue to submit
year you must decide whether you want to health care or dependent care FSA claims until
participate in one or both accounts. March 31 of the following year for eligible
expenses incurred during your employment
period. All expenses must have been incurred
during the period of coverage to be eligible
for reimbursement. The period of coverage for
the health care FSA (only) may be extended
through the Consolidated Omnibus Budget
Reconciliation Act of 1985 (COBRA). (See the
COBRA section of this booklet for more details.)
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