AtlantiCare 2022 Benefits Booklet

Legal Notices

TABLE OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 SERVICE CENTERS AND WEBSITES..........4 HOW TO ENROLL....5-6 MEDICAL..............7-13 PRESCRIPTION DRUG. ................14-16 ADDITIONAL MEDICAL PLAN RESOURCES........17-22 DENTAL...............24-25 VISION.....................26 LIFECENTER..............27 LIFE INSURANCE. .....28 DISABILITY...............29 VOLUNTARY OFFERINGS. ........30-33 SPENDING ACCOUNTS. ............34 RETIREMENT BENEFITS..................35 WELLNESS. .........36-39 LEGAL NOTICES...40-42 GLOSSARY..........43-44 FAQs...................45-47 CONTACTS.........48-49 FORMS................50-56

Legal Notice for Employer-Sponsored Wellness Programs New rules published on May 17, 2017, under the Americans with Disabilities Act (ADA) require employers that offer wellness programs that collect employee health information to provide a notice to employees informing them of what information will be collected, how it will be used, who will receive it and what will be done to keep it confidential. Notice Regarding AtlantiCare Wellness Program The Health Engagement Wellness Checklist is a voluntary wellness program available to all employees (and covered spouses). The program is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in the wellness program you will be asked to complete voluntary wellness activities, including a health risk assessment, or “HRA,” that asks a series of questions about your health-related activities and behaviors and whether you have or had certain medical conditions (e.g., cancer, diabetes or heart disease). Included in the wellness activity checklist is the option to complete a biometric screening, which will include a tobacco usage attestation, height, weight, BMI, blood pressure and (optional) lipid screening as part of an annual preventive care visit with your primary care provider. You are not required to complete the HRA, biometric screening or any other wellness activity available to you as part of the program. However, employees who choose to participate in the wellness program can earn wellness credits that are applied towards a deductible, flexible spending account or biweekly premium

reduction depending on your plan selection for completing activities on the Wellness Activity Checklist. Although you are not required to complete the HRA or participate in the biometric screening (or any other wellness activity), only employees who do so will receive the $150 wellness credit for the HRA, up to $750 wellness credit for Know Your Numbers, or additional credits associated with activities on the wellness checklist. Incentives of up to $2,000 single coverage/$4,000 family coverage for engaged plan members, up to $750 single coverage/$1,500 family coverage for PPO, and up to $750 on flexible spending account for individuals who waive coverage may be available for employees who participate in certain health-related activities as outlined on the Wellness Activity Checklist, which may include achieving certain health outcomes such as 5% weight loss or lowering blood pressure. If you are unable to participate in any of the health-related activities or achieve any of the health outcomes required to earn an incentive, you may be entitled to a reasonable accommodation or an alternative standard. You may request a reasonable accommodation or an alternative standard by contacting AtlantiCare Health Engagement at 1-609-677-7507 or wellness@atlanticare.org . Health Engagement will work with you (and, if you wish, with your doctor) to find a reasonable alternative with the same reward (or a waiver) that is right for you in light of your health status. The information from your HRA and the results from your biometric screening will be used to provide you with information to help you understand your current health and potential risks, and may also be used to offer you services through the wellness program, including, but not limited to, weight management programs, wellness coaching and additional health education classes/services pertaining to your health needs. You also are encouraged to share your results or concerns with your own doctor.

40