2018 Benefits Guide ENTER - Activision Blizzard Inc.
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2018 Benefits Guide ENTER
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE Welcome to Benefits! At Activision Blizzard, our employees build immersive worlds that impact popular NOTE ON MEDICARE: culture across the globe. We encourage you to take the same approach with your If you (and/or your dependents) have Medicare or benefits. This guide will help you explore, learn and build the best benefits to enhance will become eligible for Medicare in the next 12 months, a federal law gives you more choices your quality of life. Check out www.benefitsforeveryworld.com for more resources to help about your prescription drug coverage. Please see you find the right coverage and value for you and your family. Important Notices for more details. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL HOW TO Enrollment Steps Medical Options > CDHP Plan Programs > Activity Tracking Activision Blizzard INSURANCE BENEFITS GET HELP Choose Carefully 401(k) Plan Life Insurance Legal Services Providers > PPO 500 Plan > Food Tracking Fidelity 529 College > Basic Who is Eligible > In-Network Plan (not open > Sleep Tracking ID Theft Protection > Dependent Eligibility Verification Savings Plan > Supplemental to new enrollments) > Find Fair Prices Auto/Home/Renters Insurance > Kaiser HMO (CA only) Financial Wellbeing Accident Insurance (AD&D) > Brain Health > Basic Pet Insurance > Waiving Medical Coverage > Fertility and Pregnancy Tracking > Supplemental Additional Care Support Travel Assistance > EatWell Disability Insurance > Employee Assistance Care Providers Program (EAP) > OrderWell > Core STD and LTD > Doctor on Demand > 7 Minute Workout > Buy-up STD and LTD 24 Hour Fitness > Other Programs > Family Health Coach Supplemental Life & Income Medical Benefits Abroad Medical Plan Comparison > Personalized Health Coach Protection Mothers at Work > Whole Life Insurance > Joyful Mind Rx > Accident Insurance Call of Duty Endowment > Sleep Health > Critical Illness Dental Other Perks Annual Incentive Maximums Vision Employee Contributions Health Reimbursement Spending Accounts Account (HRA) Opt-Out > Health Savings Account > Flexible Spending Accounts Employee Contributions > Medical Plan Surcharges This guide is intended as an overview of benefits available to regular full time employees or part time employees who are benefit eligible. Temporary employees who work more than 30 hours per week should refer to the Benefits Summary for Temporary Employees located on http://www.benefitsforeveryworld.com.
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE How to Enroll Enrollment Steps Explore this guide and other tools Choose Carefully STEP 1 at www.benefitsforeveryworld.com. Your Deadline to Enroll Who is Eligible DISCOVER Choose the benefits that best suit the • Current Employees: You must enroll November 1-16, 2017. If > Dependent Eligibility needs of you and your family. you don't enroll, your current 2017 benefit elections will be Verification carried into 2018, except for flexible spending accounts. You have to enroll in those every year. It's important to make sure your • New Employees: You must enroll within 30 days from your STEP 2 providers are within the medical, start date. If you miss the deadline, you will be auto-enrolled MAP dental and vision networks to receive as described on page 5. lower out-of-pocket costs. Questions? Try www.benefitsforeveryworld.com first. If you still have questions, call the Benefits team at 888-926-2875 or email benefits@activisionblizzard.com. Build your benefits and enroll online on STEP 3 BUILD the Fusion HR website at fusionhr.activisionblizzard.com Watch for ID Cards •M edical: After open enrollment, you’ll receive a new medical ID card from Collective Health or Kaiser, if you made changes to STEP 4 Review your benefit selections and REVIEW your elections. print your confirmation statement. • Dental: If you enroll in the Dental DHMO plan, you will receive a new ID card from Delta Dental with a new dentist selected for you according to your zip code. You will need to contact Delta Dental to make a change to your dentist. Provide SSN/National IDs and If you enroll outside of open enrollment, you can expect your ID STEP 5 PROVIDE documentation for each eligible cards within two weeks from your enrollment. dependent you add to your coverage. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 3 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE CHOOSE CAREFULLY NEED TO MAKE Your Choices Last for the Plan Year A MID-YEAR The benefit elections you make start on the first of the month following your date of hire, or immediately if hired on the first of the month, and will be in effect for the rest of the plan year. BENEFIT CHANGE? Remember, you must enroll within You cannot add or remove dependents during the year, unless: 30 days of a “qualified life event,” such •Y ou have a “qualified life event” (such as marriage, divorce, birth, death or employment as marriage, divorce, birth of a child, or status change). special enrollment period. Enrollment Steps •Y ou qualify for a “special enrollment period” (such as if you waive medical, dental or If you don’t enroll within 30 days, Choose Carefully vision coverage to participate in a spouse’s plan and your coverage under that plan ends). you’ll have to wait until the next Who is Eligible If you are eligible to make mid-year changes, you must enroll within 30 days of the event. Otherwise, you open enrollment to change your > Dependent Eligibility will have to wait until the next enrollment period to make changes to your benefit elections. benefit elections. Verification For more information, please contact the Benefits Department at benefits@activisionblizzard.com. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 4 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE WHO IS ELIGIBLE You’re eligible for benefits if you’re: • A full-time or part-time, regular employee of Activision Blizzard, Blizzard Entertainment or Activision Publishing, and • Regularly scheduled to work at least 30 hours a week. You can also cover your eligible dependents: Your Spouse/Domestic Partner Enrollment Steps • Your legal spouse Choose Carefully • Your same-gender or opposite-gender domestic partner Who is Eligible Your Children > Dependent Eligibility • Children up to age 26. That means you may enroll your adult child even if he or she: Verification — No longer lives with you — Is not a dependent on your tax return — Is no longer a student — Is married (although, your child’s spouse and children are not eligible for coverage) • Dependent children of any age who are mentally or physically disabled Keep in mind, enrolling your domestic partner for medical, dental and vision coverage—as well as voluntary life and AD&D coverage—could affect your taxes. New Hires Must Enroll Within 30 Days You must enroll for benefits within 30 days of your start date. Otherwise, you’ll receive the following benefits (and will not be able to make changes until the next open enrollment unless you experience a qualified life event): IF YOU DO NOT ELECT… YOU WILL… Medical …be auto-enrolled in the CDHP Plan for yourself only Dental and Vision … have no dental or vision coverage Life Insurance and AD&D …be enrolled for two times your annual salary Short-Term Disability … be enrolled for 60% of your weekly salary Long-Term Disability … be enrolled for 40% of your monthly salary Benefits start on the first of the month following your date of hire or immediately if you are hired on the first day of the month. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 5 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE Dependent Eligibility Certification If you’re enrolling dependents for medical, dental and vision coverage during enrollment, you must add your dependents’ SSN/National IDs in Fusion and provide appropriate documentation to the Benefits Department within 30 days. Below is a list of acceptable documents. Dependent verification will also be required during the year if you make mid-year changes due to a qualified life event, such as adding a newborn baby, adopting a child, or acquiring a new dependent through marriage or by entering into a domestic partnership. To enroll a domestic partner outside of open enrollment, you must do so within 30 days of meeting the initial 6-month Enrollment Steps minimum period as defined in the Domestic Partner Declaration form. Choose Carefully DEPENDENT REQUIRED DOCUMENTATION Who is Eligible > Dependent Eligibility Spouse • Copy of marriage license/certificate Verification Domestic Partner • A state-issued Domestic Partner Declaration, or • An Activision Blizzard Affidavit of Domestic Partnership Dependent Children • Birth certificate • Document from hospital with name and date of birth • Adoption certificate/documentation • Proof of legal guardianship • Qualified medical child support order HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 6 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE Healthcare Medical Options > CDHP Plan BENEFITS TO HELP YOU STAY NEED DETAILS ABOUT > PPO 500 Plan > In-Network Plan HEALTHY AND PREPARED OUR PROVIDERS? > Kaiser HMO (CA only) Your benefit options include medical, dental and vision coverage for you and your eligible family members to > Waiving Medical Coverage Collective Health help you stay healthy, avoid serious conditions and deal with unexpected illness or accidents. Use the Collective Health Open Additional Care Enrollment Portal Support Medical Options ( http://join.collectivehealth.com/ > Employee Assistance You have a choice of medical plans so you can choose the coverage that works best for you and your Program (EAP) activisionblizzard ) to view details of family. The plan comparison charts on pages 13-19 show you how all the plans compare and the cost > Doctor on Demand Collective Health, our medical saving features each offer. If you prefer, you can waive coverage. Your options include: > Other Programs provider. You can also view dental, vision, • CDHP Plan and flexible spending accounts. Medical Plan • PPO 500 Plan Comparison • In-Network Plan (not open to new enrollments) Rx • Kaiser HMO (CA only) Dental Each medical plan option provides coverage for a full range of medical services, including office visits, Vision preventive care, inpatient care, prescription drugs and mental healthcare. Choose carefully. Spending Accounts > Health Savings Account > Flexible Spending Accounts Employee Contributions > Medical Plan Surcharges HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 7 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE Consumer Directed Health Plan (CDHP) Option If you enroll in the CDHP Plan administered by Collective Health, you must meet key requirements to open a Health Savings Account (HSA). See page 25 for more information or you can go to http://www.benefitsforeveryworld.com. The per pay period cost of this plan has not changed in five years and is less than the PPO 500 Plan, Kaiser HMO and In-Network Plan, but it has a higher annual deductible and it operates very differently. The CDHP Plan offers you the ability to choose your own providers and encourages greater control over your healthcare spending, but you should only enroll in it if you understand all of its features. The CDHP Plan works in two ways: Medical Options 1. Cost protection: Offered at no cost to you for employee-only coverage and at much > CDHP Plan lower rates for family coverage. > PPO 500 Plan 2. T ax protection: Save and pay for current and future healthcare expenses in a tax-advantaged > In-Network Plan way with the HSA. > Kaiser HMO (CA only) > Waiving Medical Coverage Additional Care Cost protection Support • Affordable (no-cost single/low-cost family) > Employee Assistance High • Your choice of in-network or out-of-network providers Program (EAP) Deductible > Doctor on Demand Health • Protection from catastrophic medical expenses > Other Programs Plan • 100% coverage for preventive care with no deductible Medical Plan Comparison Rx CDHP Dental Health Savings Tax protection Vision Account • In addition to your own pre-tax contributions, the company Spending Accounts (HSA) will contribute the following pre-tax amounts: up to $1,000 > Health Savings Account employee only coverage and $2,000 employee + dependent(s) > Flexible Spending • Tax-free reimbursements Accounts • Tax-free account growth Employee Contributions • Take it with you if you leave the company > Medical Plan Surcharges • Long-term savings vehicle • IRS limits apply: $3,450 maximum for employee only coverage and $6,900 maximum for employee + dependent(s) HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 8 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE Here’s a brief summary of how the CDHP Plan works HEALTH SAVINGS ACCOUNT (HSA) PREVENTIVE CARE If you enroll in the CDHP Plan, an HSA will be set up Preventive care (including generic preventive Is the CDHP Plan right in your name. It’s a lot like a checking account that prescription drugs) is covered at 100% with no for you? you can use to pay for qualified medical expenses. If deductible, as long as you use in-network providers. Whether this plan is right for you you don’t use your entire HSA balance during the You can get your annual check-up, health screenings, depends on many factors, including: year, you can roll it over to next year, and even take and generic preventive prescription drugs at no cost your balance with you if you leave the company. to you. Make sure your provider bills your preventive • Your comfort with a high deductible Your HSA is made up of three types of contributions: services as preventive or routine instead of and out-of-pocket limit (remember the automatic company contributions, earned company diagnostic. company helps fund more than half of Medical Options contributions, and your own contributions. the deductible by contributing up to > CDHP Plan $1,000 for employee-only coverage and NON-PREVENTIVE CARE > PPO 500 Plan $2,000 for employee + dependent(s)). ACTIVISION BLIZZARD CONTRIBUTION For other types of healthcare services, including > In-Network Plan The annual deductible is higher than our other doctor visits for illness and non-preventive > Kaiser HMO (CA only) plans. To help fund it, Activision Blizzard will make prescription drugs, you can go to the provider of •If you have the resources to contribute > Waiving Medical Coverage a contribution to each enrolled employee’s HSA on your choice and pay for your care using your HSA. to the HSA and gain the tax advantages Additional Care January 1, 2018. If you have employee-only You may also choose to pay for your care out of (consider depositing the savings in Support coverage, you get $250; if you have covered your own pocket if you want to save your HSA premiums you would pay for another > Employee Assistance dependent(s), you get $500. funds for future use. To maximize your benefit, we more expensive plan). Program (EAP) encourage you to use Collective Health in-network > Doctor on Demand BENEFITS@PLAY CONTRIBUTIONS providers. A list of Collective Health network • The amount of non-preventive services > Other Programs you expect to use, like ER visits, If you are enrolled in the CDHP Plan with an HSA you providers can be found here. Medical Plan can earn an additional $750 for employee-only coverage physician and hospital services you Comparison and $1,500 for employee + dependent(s) coverage by COINSURANCE might receive if you are ill. Rx engaging in healthy activities in the Benefits@Play Once you satisfy the annual deductible, the plan program (see more information on page 30). begins paying a percentage of your costs for eligible • Whether you plan to engage in the Dental healthcare and prescription drug benefits. Keep in Benefits@Play healthy activities to earn Vision YOUR OWN CONTRIBUTIONS mind that your costs will be lower if you use in- incentive payments to help offset the You can also deposit your own funds, tax-free, to network providers. deductible. Spending Accounts > Health Savings Account your HSA up to the IRS limits listed in the table on It is important to understand that all eligible > Flexible Spending page 25. Please keep in mind that employer HSA DOLLARS ROLL OVER non-preventive services and prescriptions Accounts contributions (automatic and earned) are subject If you don’t use all of your HSA dollars, they roll over you receive are applied toward your to the annual IRS limits. to the next year, and if you leave the company, your Employee deductible until it is met and then the plan HSA is yours to take with you. pays 80% of in-network charges. You can Contributions JOINING MID-YEAR use your HSA account to pay for these > Medical Plan Surcharges If you join Activision Blizzard mid-year, you can enroll IF YOU HAVE AN HSA—NO FSA OR HRA eligible out-of-pocket medical expenses. in the CDHP Plan and the automatic HSA company Because the HSA is a tax-advantaged account, the contribution will be prorated for the pay periods that IRS will not allow you to have both an FSA or HRA remain in the year. You will be subject to the full-year and an HSA. If you are covered by any other health deductible under the CDHP Plan, regardless of your plan that does not have a qualifying high deductible, date of hire. you are also not eligible to participate in the HSA. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 9 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE PPO 500 Plan Option Waiving Medical Coverage Like the CDHP Plan, the PPO 500 Plan is You may waive medical coverage if you have qualifying WANT MORE administered by Collective Health and offers you a healthcare coverage through another source (for INFORMATION? choice every time you need care. You can receive example, your spouse’s employer’s health plan). You'll find it all at: care from an in-network provider or an out-of- network provider without a referral. The plan ATTESTATION FOR OTHER GROUP http://www.benefitsforeveryworld.com or includes a national network of doctors, hospitals HEALTH PLAN COVERAGE just click the direct links below: and other healthcare providers that provide Due to various federal tax law requirements, access services at contracted rates. The PPO 500 Plan to an HRA account can only be available if you and Collective Health website Medical Options also includes the Blue Shield network (Blue Card your dependents are enrolled in an employer- https://join.collectivehealth.com/ > CDHP Plan nationwide) which is a broad network of doctors sponsored “group health plan” that meets specific activisionblizzard > PPO 500 Plan and facilities. minimum value requirements under the Affordable > In-Network Plan Care Act (ACA). Note that health coverage CVS/Caremark Pharmacy website > Kaiser HMO (CA only) When you receive care from an obtained through government sponsored plans https://www.caremark.com/wps/portal > Waiving Medical Coverage in-network provider: (such as Medicare, Medicaid, Tricare, etc.) or other Additional Care • You have a lower annual deductible non-group health plan insurance (such as individual Kaiser website health policies or ACA Marketplace plans) is not Support • You have a lower out-of-pocket maximum https://healthy.kaiserpermanente.org/ > Employee Assistance considered to be “group health plan” coverage for Program (EAP) • Your copay/coinsurance is less purposes of ACA rules. Thus, if you have elected Delta Dental website > Doctor on Demand not to participate in Activision Blizzard’s medical https://www.deltadentalins.com/ > Other Programs In-Network Options plans, you must attest that you and if applicable, activisionblizzard/ your spouse and dependent children, are enrolled in Medical Plan Depending on your location, choose from: another employer-sponsored group health plan that Comparison • Kaiser HMO (CA only) Vision Service Provider (VSP) website meets the ACA’s minimum value requirements: https://www.vsp.com/ Rx • In-Network Plan (not open to new enrollments) Although I have elected to waive coverage under Dental Network-only plans generally cover only those the Activision Blizzard’s group health plans, I attest EAP website Vision services provided by in-network providers, except that I and if applicable, my spouse and/or http://www.magellanhealth.com/member for certain emergency situations. In the HMO, dependent children, are enrolled in other Spending Accounts you choose a primary care physician (PCP) who employer-sponsored group health plan coverage > Health Savings Account coordinates your care and makes referrals to that meets the minimum value requirements > Flexible Spending in-network specialists. Each family member may under the ACA. Accounts select a different PCP. (The In-Network Plan is Employee Note: If your circumstances change and you (or if applicable, administered by Collective Health and does not your spouse and/or dependent child(ren) are no longer Contributions require coordination through a PCP.) Most services enrolled in an employer-sponsored group health plan, you will > Medical Plan Surcharges are covered in full after you pay a copay. not be eligible to participate in, or have access to, your HRA. Please notify Benefits@activisionblizzard.com in the event that you, or your spouse and dependent children, are no longer enrolled in an employer-sponsored group health plan. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 10 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE ADDITIONAL CARE SUPPORT DOCTOR ON DEMAND Employee Assistance Other Medical Programs ADVANTAGES Program (EAP) available to Collective Health The EAP is a free, confidential counseling and referral Members Convenient. Get care 7 a.m. – 11 p.m. service through Magellan Health that can help you no matter where you are in the U.S. with personal or work-related issues. The EAP offers Healthcare Bluebook up to six free face-to-face sessions per incident each Healthcare Bluebook is a healthcare shopping Fast. No waiting for an appointment. Get year. Call the EAP at 800-327-2593, 24/7 to get web/mobile tool that you and your dependents an immediate diagnosis and, if needed, Medical Options information and referrals to counselors, dependent can use to earn incentives to find Fair Prices™ a prescription, and start treating your > CDHP Plan of high quality in-network providers of certain condition right away. care, legal and financial resources. You can also > PPO 500 Plan medical procedures and tests. contact the EAP to access resource and referral > In-Network Plan Save money. It’s a cost-effective services for child care and parenting, pregnancy and > Kaiser HMO (CA only) adoption, daily life issues and more. Livongo for Diabetes alternative to urgent care or the > Waiving Medical Coverage If you or a covered family member has diabetes, emergency room. Additional Care you (or your dependent, as applicable) will be Support Video Telemedicine (Doctor invited to participate in Livongo, a diabetes Superior care. You’ll be talking face-to-face > Employee Assistance on Demand) management program. Livongo provides you with over video with a network board-certified Program (EAP) a wireless blood glucose meter with no-cost testing If you’re enrolled in one of the Collective Health physician who will share a report with your > Doctor on Demand supplies, 24/7 online support, and education. medical plans (not available with Kaiser HMO), regular doctor. > Other Programs Activision Blizzard has partnered with Doctor on Medical Plan Demand, a video telemedicine service to provide Grand Rounds Medical Expert To get started, go to Comparison medical care for you and your family in a convenient Second Opinion Referral Service www.DoctorOnDemand.com/ab or location of your choice at no charge (if you’re When you need expert medical advice, Grand call 800-997-6196. Rx enrolled in the PPO 500 or In-Network medical Rounds is with you. This health benefit, covered in Dental plans). If you’re enrolled in the CDHP Plan, you will full by Activision Blizzard, helps you get a second Vision pay $49 until you satisfy the deductible, and then opinion or personalized care plan for any diagnosis the service is offered at no charge. from a world-leading expert. To get started, visit Spending Accounts https://www.grandrounds.com/activisionblizzard > Health Savings Account You will have access to physicians who can diagnose, or call 800-929-0926. > Flexible Spending Accounts treat, and write prescriptions for routine medical conditions such as: cold and flu, ear infections, sinus Progyny for Fertility Employee Progyny provides improved infertility treatment problems, etc. This service is available 7 days a week Contributions and clinical quality, plus support for adoption/ from 7 a.m. – 11 p.m. (including holidays) by video > Medical Plan Surcharges surrogacy resources as well as fertility from practically anywhere. preservation/egg-freezing. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 11 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE Other Medical Programs Available to Everyone Rethink Autism Rethink is an effective, web-based program that puts clinical best practice treatment solutions at your fingertips at no cost to you. You also can receive 7 one-hour coaching sessions. There is no requirement for an individual to have been diagnosed with autism to use the Rethink program. Ovia Fertility, Pregnancy and Parenting Ovia Fertility and Ovia Pregnancy Tracking are two programs available through a partnership with Ovia, a company focused on using data and technology to help couples understand their unique health and make beautiful babies. Medical Options > CDHP Plan > PPO 500 Plan Female employees and spouses/domestic partners are eligible to participate. Participation is optional, confidential and > In-Network Plan voluntary. Access the programs within the Jiff app by selecting “Program Catalog” under the “More” menu. Participants also > Kaiser HMO (CA only) may take advantage of Ovia's growing array of parenting resources when these programs become available. > Waiving Medical Coverage Additional Care Wellthy Wellthy helps individuals and families manage and coordinate care for a chronically ill, aging, or disabled loved one. Support > Employee Assistance Program (EAP) With Wellthy, you’ll get connected with a Care Coordinator who has skills and experience that match your needs. Your Care > Doctor on Demand Coordinator will then create a personalized plan for you and get to work researching, calling, and getting things done, so you > Other Programs can focus on taking care of yourself or your loved one. Wellthy is available at no cost to you. Medical Plan Robin Care Comparison Robin Care offers patients and caregivers comprehensive cancer care support. Rx Dental With Robin Care, each patient has 24/7 access to a team of coaches and nurses to help them navigate their journey. The web and mobile apps provide education, tools, and resources to empower patients every step of the way. Robin Care is included in Vision your plan at no cost to you. Spending Accounts > Health Savings Account > Flexible Spending Accounts Employee Contributions > Medical Plan Surcharges HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 12 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE MEDICAL PLAN COMPARISON CDHP AND PPO OPTIONS CDHP PPO 500 Features In-Network Out-Of-Network In-Network Out-Of-Network Activision Blizzard Contribution $250/$500 N/A N/A N/A Medical Options Individual/Family > CDHP Plan > PPO 500 Plan > In-Network Plan > Kaiser HMO (CA only) Annual Deductible $1,500/$3,000 $4,000/$8,000 $500/$1,000 $1,000/$2,000 Individual/Family > Waiving Medical Coverage Additional Care Support Coinsurance Employer/ > Employee Assistance 80/20 50/50 90/10 70/30 Individual Program (EAP) > Doctor on Demand > Other Programs Annual Out-of-Pocket Maximum $4,500/$9,000 $6,350/$12,700 $3,000/$6,000 $4,000/$8,000 Medical Plan Individual/Family Comparison COVERED EXPENSES Rx What You Pay Dental Vision Primary Care Physician 20% after deductible 50% after deductible $20 copay 30% after deductible Office Visits Spending Accounts > Health Savings Account > Flexible Spending Accounts Specialist Office Visits 20% after deductible 50% after deductible $45 copay 30% after deductible Employee Contributions > Medical Plan Surcharges HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 13 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE CDHP AND PPO OPTIONS CDHP PPO 500 Features In-Network Out-Of-Network In-Network Out-Of-Network Preventive Care • Adult and children from age 17 No charge 50% after deductible $0 copay 30% after deductible • Well-child care through age 16 Medical Options > CDHP Plan Lab and X-ray 20% after deductible 50% after deductible 10% after deductible 30% after deductible > PPO 500 Plan > In-Network Plan > Kaiser HMO (CA only) Initial visit: $20 copay for > Waiving Medical Coverage primary care Additional Care physician Support Maternity Care 20% after deductible 50% after deductible $45 copay for specialist 30% after deductible > Employee Assistance Program (EAP) 10% after deductible for > Doctor on Demand prenatal, postnatal and physician’s charges > Other Programs Medical Plan Comparison Inpatient Care 20% after deductible 50% after deductible 10% after deductible 30% after deductible Rx Dental Vision Outpatient Care 20% after deductible 50% after deductible 10% after deductible 30% after deductible Spending Accounts > Health Savings Account > Flexible Spending No charge after No charge after Ambulance $0 copay $0 copay Accounts deductible deductible Employee Contributions $49 charge until > Medical Plan Surcharges Video Telemedicine deductible is met, Not available $0 copay Not available then no cost HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 14 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE CDHP AND PPO OPTIONS CDHP PPO 500 Features In-Network Out-Of-Network In-Network Out-Of-Network 20% 20% $50 copay; $50 copay: Urgent Care after deductible after deductible no deductible no deductible $200 copay; $200 copay; 20% 20% Medical Options Emergency Room Visits after deductible after deductible no deductible no deductible > CDHP Plan (waived if admitted) (waived if admitted) > PPO 500 Plan > In-Network Plan Durable Medical No charge 50% > Kaiser HMO (CA only) $0 copay 30% after deductible Equipment after deductible after deductible > Waiving Medical Coverage Additional Care Short-Term Support Rehabilitative Therapy > Employee Assistance and Chiropractic Care Program (EAP) Includes physical and occupational therapy at $20 copay for primary > Doctor on Demand 20% 50% 30% 30 sessions each; speech care physician; > Other Programs after deductible after deductible after deductible therapy and chiropractic $45 copay for specialist Medical Plan care at 60 sessions each per calendar year Comparison Rx Dental Vision Spending Accounts > Health Savings Account > Flexible Spending Accounts Employee Contributions > Medical Plan Surcharges HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 15 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE CDHP AND PPO OPTIONS CDHP PPO 500 Features In-Network Out-Of-Network In-Network Out-Of-Network Treatment of Autism Includes office visits; speech, occupational and physical therapy; psychotherapy; and ABA therapy to manage Medical Options behavioral issues related to > CDHP Plan autism. Unlimited maximum > PPO 500 Plan per calendar year. 20% 50% $45 copay 30% after deductible after deductible for specialist after deductible > In-Network Plan > Kaiser HMO (CA only) Rethink Autism is a > Waiving Medical Coverage web-based program that offers clinical best practice Additional Care treatment solutions at Support no cost. In addition, you > Employee Assistance can receive 7 one-hour Program (EAP) coaching sessions. > Doctor on Demand > Other Programs Treatment of Gender Charge based on Charge based on Charge based on Charge based on Identity Disorder site of service site of service site of service site of service Medical Plan Comparison Treatment of Infertility Coverage is through Rx Progyny, a concierge fertility Charge based on Charge based on Dental benefit. It provides members Not covered Not covered site of service site of service with one smart cycle per Vision lifetime and a full suite of fertility treatment options. Spending Accounts > Health Savings Account > Flexible Spending Inpatient Mental Health/ 20% 50% 10% 30% Accounts Substance Abuse after deductible after deductible after deductible after deductible Employee Contributions > Medical Plan Surcharges Outpatient Mental Health/ 20% 50% 30% $20 copay Substance Abuse after deductible after deductible after deductible HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 16 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE MEDICAL — NETWORK-ONLY OPTIONS KAISER HMO COLLECTIVE HEALTH (CA ONLY) IN-NETWORK* Features In-Network In-Network Annual Deductible None None Individual/Family Annual Out-of-Pocket Maximum $1,500/$3,000 $1,500/$3,000 Individual/Family Medical Options > CDHP Plan COVERED EXPENSES > PPO 500 Plan What You Pay > In-Network Plan > Kaiser HMO (CA only) Primary Care Physician Office Visits $20 copay $20 copay > Waiving Medical Coverage Additional Care Support Specialist Office Visits $35 copay $35 copay > Employee Assistance Program (EAP) Preventive Care > Doctor on Demand • Adult and children from age 17 $0 copay $0 copay • Well-child care through age 16 > Other Programs Medical Plan Lab and X-ray $0 copay $0 copay Comparison Rx Initial visit: $20 copay for Dental primary care physician $0 copay for office visits Maternity Care $35 copay for specialist Vision $250 copay for delivery $0 for subsequent visits Spending Accounts > Health Savings Account $300 copay for delivery > Flexible Spending Accounts Inpatient Care $250 copay $300 copay Employee Contributions Outpatient Care $100 copay $100 copay > Medical Plan Surcharges Ambulance $0 copay $0 copay *Not open to new enrollments HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 17 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE MEDICAL — NETWORK-ONLY OPTIONS KAISER HMO COLLECTIVE HEALTH (CA ONLY) IN-NETWORK* Features In-Network In-Network $100 copay $200 copay Emergency Room Visits (waived if admitted) (waived if admitted) Medical Options Video Telemedicine Not available $0 copay > CDHP Plan > PPO 500 Plan > In-Network Plan > Kaiser HMO (CA only) Urgent Care $20 copay $50 copay > Waiving Medical Coverage Additional Care Support > Employee Assistance Durable Medical Equipment $0 copay $0 copay Program (EAP) > Doctor on Demand > Other Programs Short-Term Rehabilitative Therapy and $20 copay per office visit for physical Chiropractic Care occupational and speech therapy $20 copay for primary care physician Medical Plan Includes physical, speech, occupational, Comparison chiropractic, pulmonary rehabilitation, and $10 copay per office visit $35 copay for specialist; unlimited visits cognitive therapy for chiropractic care Rx Dental Treatment of Autism Vision Includes office visits; speech, occupational and physical therapy; psychotherapy; and Spending Accounts ABA therapy to manage behavioral issues > Health Savings Account Covered the same as other illness/Rx related to autism. Unlimited maximum per > Flexible Spending Covered the same as other illness/Rx (subject to applicable specialist copay) calendar year. (subject to applicable specialist copay) Accounts Unlimited maximum per calendar year Rethink Autism is a web-based program Employee that offers clinical best practice treatment Contributions solutions at no cost. In addition, you can > Medical Plan Surcharges receive 7 one-hour coaching sessions. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 18 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE MEDICAL — NETWORK-ONLY OPTIONS KAISER HMO COLLECTIVE HEALTH (CA ONLY) IN-NETWORK* Features In-Network In-Network Charge based on site Charge based on site Treatment of Gender Identity Disorder of service of service Coverage is through Progyny, a concierge Medical Options Coverage includes services for the fertility benefit. It provides members with > CDHP Plan Treatment of Infertility diagnosis and treatment of involuntary one smart cycle per lifetime and a full suite > PPO 500 Plan infertility; 50% coinsurance of fertility treatment options. > In-Network Plan > Kaiser HMO (CA only) > Waiving Medical Coverage Inpatient Mental Health/Substance Abuse $250 copay $300 copay Additional Care Support > Employee Assistance Outpatient Mental Health/Substance $20 copay Program (EAP) $20 copay Abuse (individual visit) > Doctor on Demand > Other Programs *Not open to new enrollments Medical Plan Comparison Rx Dental Vision Spending Accounts > Health Savings Account > Flexible Spending Accounts Employee Contributions > Medical Plan Surcharges HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 19 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE PRESCRIPTION DRUGS expensive at first, but that’s why the company contributes money to your HSA. You can use your HSA debit card at the pharmacy to help cover Under each medical plan, generic preventive drugs are covered at those higher costs. 100%. You’ll also pay less when you buy regular generic drugs or use After you meet the deductible, you pay copays for generic drugs and mail-order for ongoing medications. But, prescription benefits work coinsurance for brand names. much differently under the Collective Health CDHP Plan than the traditional medical plans (i.e., Collective Health PPO and In-Network plans and HMO). Collective Health PPO and In-Network plans and HMO Under these traditional medical plans, you pay copays for generic and Collective Health CDHP Plan brand-name drugs, even if you haven’t met the deductible. Generally, Medical Options With the exception of generic preventive medications which are always > CDHP Plan copays are lower for generics and higher for preferred and non- covered at 100%, you pay the full cost of prescriptions until you meet > PPO 500 Plan preferred brand names. the annual deductible. Your initial visits to the pharmacy may be more > In-Network Plan > Kaiser HMO (CA only) > Waiving Medical Coverage MEDICAL — CDHP AND PPO OPTIONS Additional Care CDHP PPO 500 Support > Employee Assistance Features In-Network Out-of-Network In-Network Out-of-Network Program (EAP) > Doctor on Demand PRESCRIPTION DRUGS (generic/preferred brand/non-preferred brand) > Other Programs Retail Pharmacy Preventive generics: Deductible and 50% Preventive generics: 40% after deductible 30-day supply 100% covered coinsurance 100% covered Medical Plan (You are not required to Generic: $4 copay after Generic: $10 copay Comparison use a CVS pharmacy) deductible Preferred Brand: $30 copay Rx Preferred Brand: 20% ($20 min/$45 max) after deductible Non-Preferred Brand: Dental $60 copay Non-Preferred Brand: 35% Vision ($40 min/$100 max) after Copay increases by $10 for deductible select maintenance drugs Spending Accounts after the second refill > Health Savings Account Copay increases by $10 for select maintenance drugs > Flexible Spending after the second refill Accounts Home Delivery Preventive generics: Not covered Preventive generics: Not covered Employee 90-day supply 100% covered 100% covered Contributions (Available at CVS retail at Generic: $10 copay after Generic: $20 copay > Medical Plan Surcharges home delivery pricing) deductible Preferred Brand: $60 copay Preferred Brand: 20% ($50 min/$125 max) after Non-Preferred Brand: deductible $120 copay Non-Preferred Brand: 35% ($70 min/$175 max) after deductible HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 20 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE MEDICAL — NETWORK-ONLY OPTIONS KAISER HMO COLLECTIVE HEALTH (CA ONLY) IN-NETWORK* Features In-Network In-Network PRESCRIPTION DRUGS - CVS/CAREMARK Retail Pharmacy Generic: $10 copay Preventive generics: 100% covered Up to 30-day supply (You are not required to use a CVS Brand: $30 copay Generic: $10 copay pharmacy for the In-Network Plan) Medical Options Preferred Brand: $30 copay > CDHP Plan > PPO 500 Plan Non-Preferred Brand: $60 copay; copay > In-Network Plan increases by $10 for select maintenance drugs after the second refill > Kaiser HMO (CA only) > Waiving Medical Coverage Home Delivery Generic: $20 copay Preventive generics: 100% covered Up to a 90-day supply** Additional Care (Available at CVS retail at home delivery Brand: $60 copay Generic: $20 copay Support > Employee Assistance pricing for the In-Network Plan) Preferred Brand: $60 copay Program (EAP) > Doctor on Demand Non-Preferred Brand: $120 copay > Other Programs *Not open to new enrollments Medical Plan **100-day supply applies to Kaiser HMO Comparison Rx Dental Vision Spending Accounts > Health Savings Account > Flexible Spending Accounts Employee Contributions > Medical Plan Surcharges HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 21 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE DENTAL To keep those pearly whites healthy, Activision Blizzard offers the flexibility to choose a dental plan that SOMETHING TO fits your and your family’s needs. You can choose from two Delta Dental plans or waive coverage. SMILE ABOUT •D elta Dental PPO. This plan pays benefits for covered services provided by any in- or out-of- network dentist. However, you can save money by using a dentist who participates in the Delta Both dental plans offer preventive care Dental PPO network. That’s because in-network dentists have agreed to provide services at lower, exams, basic services and major services. contracted rates. For out-of-network services, you’ll pay a percentage of the covered expenses, plus The difference is in who you can see and any amounts above reasonable and customary (R&C) charges. how much you pay. Medical Options You will not receive a Dental PPO ID card. To verify coverage, just give your dental provider your plan’s If you need more info, visit > CDHP Plan group number: 17915 https://www.deltadentalins.com/ > PPO 500 Plan • DeltaCare USA DHMO. This plan generally covers only those services provided by an in-network dentist. activisionblizzard/ or call: > In-Network Plan This cost-effective plan pays 100% of most services after you pay a copay. For each family member, you • HMO: 800-422-4234, or > Kaiser HMO (CA only) must use an in-network Primary Care Dentist who will coordinate any treatments by in-network > Waiving Medical Coverage • PPO: 800-765-6003. specialists. To verify coverage, just give your dental provider your plan’s group number: 78613 Additional Care You will receive a Delta Dental DHMO ID card with an auto-generated dentist based on your zip code Support in the mail to present to your dental provider at the time of service. If you need to change your dentist, > Employee Assistance Program (EAP) call Delta Dental at 800-422-4234. > Doctor on Demand > Other Programs DENTAL OPTIONS Medical Plan DELTA DENTAL PPO DELTACARE USA DHMO (NOT IN MN) Comparison Features In-Network Out-Of-Network In-Network Rx Annual Deductible Individual/Family $50/$150 None Dental Annual Dental Maximum $2,000 N/A Vision Spending Accounts Lifetime Orthodontic Maximum $2,000 N/A > Health Savings Account COVERED SERVICES What You Pay > Flexible Spending Accounts Preventive Services $0 except amounts above $0 copay Copays vary Exams, cleanings, X-rays contract allowance* Employee Contributions Basic Services Fillings, root canal 20% after deductible 20% after deductible, plus amounts Copays vary > Medical Plan Surcharges therapy above contract allowance* Major Services Crowns, bridges, 50% after deductible, plus amounts 50% after deductible Copays vary dentures and implants above contract allowance* 50% after deductible, plus amounts Orthodontics Children and adults 50% after deductible Copays vary above contract allowance* *Contract allowance — PPO contracted fees for PPO Dentists, Delta Dental Premier® contracted fees for Premier Dentists and the program allowance for non-Delta Dental Dentists. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 22 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE VISION Are you squinting? Well, don’t worry. Good vision is on the horizon with Activision Blizzard vision coverage. You always have a choice of eye care providers. When you receive care from an: • I n-network provider (VSP Signature Network), your costs will be lower. You don’t have to fill out any forms or file any claims. •O ut-of-network provider (Non-VSP provider), you will typically pay more out of pocket. You pay the provider in full and submit a claim to VSP for reimbursement. The plan has a set reimbursement amount for each service. Medical Options Just give your SSN/National ID to the VSP provider and they will be able to verify your coverage. Questions? > CDHP Plan Go to https://www.vsp.com or call 800-877-7195. > PPO 500 Plan > In-Network Plan > Kaiser HMO (CA only) > Waiving Medical Coverage VISION VSP Additional Care Support In-Network Out-Of-Network > Employee Assistance Features (VSP Network Provider) (Non-VSP Provider) Program (EAP) > Doctor on Demand Copay $15 N/A > Other Programs Medical Plan Comparison COVERED SERVICES What You Pay Rx Exam $0 after copay You receive up to $50 allowance Dental Once every 12 months Vision Spending Accounts > Health Savings Account Frames After copay, you receive up to $130 You receive up to $70 allowance > Flexible Spending Once every 24 months allowance plus 20% off any out-of Accounts pocket costs Employee Contributions > Medical Plan Surcharges HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 23 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE VISION VSP In-Network Out-Of-Network Features (VSP Network Provider) (Non-VSP Provider) Lenses $0 after copay You receive an allowance of: Once every 12 months • Single vision • Up to $50 • Lined bifocal • Up to $75 Medical Options • Lined trifocal • Up to $100 > CDHP Plan If you choose contact lenses, you will be > PPO 500 Plan eligible for a frame 12 months from the > In-Network Plan date the contact lenses were obtained > Kaiser HMO (CA only) > Waiving Medical Coverage Lens Options You receive an allowance of: You receive an allowance of: • Standard progressive lenses • Up to $50 • Up to $75 Additional Care • Premium progressive lenses • $80 - $90 Support • Custom progressive lenses • $120 - $160 > Employee Assistance Program (EAP) > Doctor on Demand > Other Programs Contact Lenses Up to $60 copay for contact lens exam You receive up to $105 allowance Medical Plan Once every 12 months instead of frames (fitting and evaluation) and $115 allowance and lenses for cost of contact lenses Comparison Rx Dental Vision Laser Vision Correction LASIK vision correction, up to $1,000 per eye; once per lifetime Average of 15% off the regular price or 5% off the promotional price from Spending Accounts contracted facilities > Health Savings Account > Flexible Spending Accounts Employee Contributions Note: If you purchase vision services/products through the plan at Costco or any other VSP Affiliate Provider, no claim form is needed. > Medical Plan Surcharges HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 24 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE SPENDING ACCOUNTS IF YOU WANT TO Health Savings Account (pairs with the CDHP Plan) ENROLL IN AN HSA, YOU A Health Savings Account (HSA) is a tax-favored individual account that you can either use to pay current medical, dental and vision expenses or use to save money for future healthcare expenses. By law, you can NEED TO MEET THESE only enroll in an HSA if you have a high deductible health plan, such as the CDHP Plan. REQUIREMENTS: Why open an HSA? • Be enrolled in the CDHP Plan There are several perks to opening an HSA: • Not be covered by any other medical Medical Options • You decide when and how to spend the money. plan that is not a high-deductible > CDHP Plan health plan (defined as an individual • Whatever funds you don’t use by the end of the year will roll over to the next. > PPO 500 Plan deductible of $1,350 and employee > In-Network Plan • If you leave the company or change insurance coverage, the account is yours to keep. + dependent deductible of $2,700), > Kaiser HMO (CA only) • At the beginning of the year, Activision Blizzard will make a contribution in your HSA for enrolling in even if it is through a spouse’s > Waiving Medical Coverage the CDHP Plan. coverage. Additional Care • You will also then have the ability to earn additional Benefits@Play incentive dollars from the company • Not be enrolled in a healthcare FSA; Support if you participate in healthy activities as defined by the company during the plan year. you are considered to be covered by > Employee Assistance Program (EAP) • Your contributions are taken from your paycheck and then applied to your HSA account. an FSA or HRA even if your spouse is > Doctor on Demand enrolled in an FSA. > Other Programs • Not be claimed as a dependent on HSA Contributions If You Choose The CDHP Plan someone else’s tax return. Medical Plan Comparison YOUR 2018 EMPLOYEE + • Not be enrolled in Medicare. EMPLOYEE ONLY Rx HSA CONTRIBUTIONS DEPENDENT(S) Dental Company Contribution $250 $500 Vision Spending Accounts Benefits@Play Incentives $750 $1,500 > Health Savings Account > Flexible Spending Your Annual Contributions* Up to $2,450 Up to $4,900 Accounts Employee Total allowed by the IRS in 2018** $3,450 $6,900 Contributions > Medical Plan Surcharges * If you are age 55 or older, you can contribute an extra $1,000 to your HSA in 2018. ** This includes Activision Blizzard’s contribution, any Benefits@Play incentives you and/or your spouse/domestic partner earn and your own contributions. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 25 > INSURANCE
BENEFITS FOR EVERY WORLD 2018 BENEFITS GUIDE How much can I contribute annually to an HSA? •Y ou can make changes to your HSA contributions any In 2018, employees with Employee-only coverage are limited to $3,450 time you wish. and those with Employee + Dependent(s) coverage are limited to •Y ou may deposit funds directly into your HSA outside of $6,900, and this includes Activision Blizzard contributions. If you are age payroll deduction. 55 or older, you can contribute an extra $1,000 to your account, or • You will be responsible for tracking your medical, dental and vision $2,000 if you cover dependents. expenses and reporting them on your annual tax return. You need to keep your receipts in the event of an IRS inquiry. Are there any fees for the HSA? There are no fees for employees. Activision Blizzard covers the monthly maintenance fees. Who is the administrator of the HSA? Medical Options The HSA is administered by Collective Health. > CDHP Plan Is the HSA transferable upon death? > PPO 500 Plan You can elect a beneficiary, but if no beneficiary is specified, it will What happens to the HSA if the company selects > In-Network Plan transfer to your estate. an insurance company other than Collective > Kaiser HMO (CA only) Health in the future? > Waiving Medical Coverage You will always own the funds in the HSA. If the company were to switch Are there investment options with the HSA? Additional Care You must have a minimum balance of $2,000 to have investment options. to a new insurance company, the funds in your HSA would still be yours, Support HSA investment account options provide: and you would have the option to roll them over to an HSA with the new > Employee Assistance insurance company. Program (EAP) • Opportunities for long-term investments. If you are interested in investing for the future, the HSA investment account complements > Doctor on Demand Can I enroll in the HSA if I have the PPO, Kaiser your interest earning HSA cash account. Investments in mutual funds > Other Programs HMO or In-Network medical plan? roll over from year to year, accumulate in a tax-deferred manner and Medical Plan No. By law, you can only enroll in the HSA if you’re enrolled in the CDHP are portable. Comparison Plan. If you are enrolled in the PPO, In-Network or Kaiser HMO, you can • Low investment thresholds. To open the HSA investment account, only enroll in the Healthcare FSA. Rx you need to transfer a minimum of $2,000 from your cash account Dental to the investment account. After the initial transfer of $2,000, this What happens if I have an HRA and/or an FSA and I Vision threshold does not need to be maintained in the investment account. want to switch to the CDHP Plan with HSA in 2018? In addition, there is no minimum that needs to be maintained in your If you are contemplating a switch to the CDHP Plan with HSA, and you Spending Accounts cash account. currently have either an HRA or FSA, there are IRS requirements that > Health Savings Account prevent establishment of an HSA while you have an active HRA or FSA: > Flexible Spending Accounts How is the HSA different than the Flexible •Y our HRA will end on December 31, 2017, and any eligible Spending Account (FSA)? expenses incurred in 2017 must be submitted for reimbursement Employee There are several differences between the HSA and the FSA. by December 31, 2017. If you have a balance remaining at the Contributions end of the year, you will be automatically enrolled in a Limited With the HSA: > Medical Plan Surcharges • Funds are only available as they are deposited. With the Healthcare Purpose HRA. You can use the money in the account to pay for FSA, the full amount that you elect to contribute is available to you at eligible dental and vision expenses. the beginning of the plan year. •Y our FSA will end on December 31, 2017, and any eligible • Any unused funds at the end of the year will roll over to the next — expenses incurred in 2017 must be submitted for reimbursement there is no “use it or lose it” rule. With the FSA, you lose any unused by December 31, 2017. Any unused FSA dollars will be forfeited. funds at the end of the year. HOW TO ENROLL HEALTHCARE BENEFITS@PLAY WEALTHCARE LIFE & DISABILITY ADDITIONAL BENEFITS HOW TO GET HELP < 26 > INSURANCE
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