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Assurant Health and Welfare Plan 2019 Summary Plan Description

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Assurant Health and Welfare Plan 2019 Summary Plan Description Assurant Health and Welfare Plan 2019 Summary Plan Description October 8, 2018 New York, NY Main Table of Contents Getting to Know Your Assurant Benefits .....................................................3 Assurant Health and Welfare Plan ..............................................................4 Assurant Health Plan ...................................................................................14 Prescription Drug Coverage.........................................................................57 Employee Assistance Program .....................................................................64 Dental Plan ..................................................................................................67 Flexible Spending Accounts ........................................................................77 Life and Accident Insurance ........................................................................89 Disability Plan .............................................................................................106 Group Insurance ..........................................................................................120 Tuition Reimbursement Plan .......................................................................125 Commuter Benefits Program .......................................................................130 Severance Pay Plan .....................................................................................132 Plan Administration .....................................................................................137 Required Notices .........................................................................................149 Glossary .......................................................................................................162 Assurant Community Commitment Report • 2019 Summary Plan Description 2 page 3 Getting to Know Your Assurant Benefits Quality, Protection, Value Your compensation is much more than your paycheck. There also is an enormous value to the benefits Assurant provides. In fact, company-provided benefits are often called the “hidden paycheck.”And just as we all decide for ourselves how to spend our cash compensation, we all have different priorities when it comes to our company-provided benefits. Assurant’s range of benefit plans gives you and your family protection and flexibility in setting your benefit priorities. Our health care plan helps you preserve your good health and helps cover the cost of your medical care if you are ill or injured. Other benefit plans ensure that a portion of your income is protected if you’re sick or disabled and that your family is protected financially if you die. Assurant believes we should work together to get the best value for our benefit dollars.The company currently provides certain benefits at no cost to you. The company also shares in the cost of some of the optional benefits available. By working together, we can make the most of our benefits and Assurant also can continue to provide you with market-competitive benefits. Defined terms are in italics and their definitions are in found in the Glossary. Disclaimers While the company intends to continue these benefits, it reserves the right to change or terminate them in its sole discretion, at any time. In the event of any discrepancy between the information contained in this SPD and the Plan document, the Plan document will control. If you have questions about the benefits offered by Assurant, contact HR Services at 866.324.6513 or via email at [email protected]. For Assurant employees who are part of the former The Warranty Group and any new hires within Global Automotive, note there are references throughout the site regarding where to enroll and where to conduct benefits transactions as MyEPIC and MyHR.You’ll continue to enroll and conduct these transactions in Workday. 2019 Summary Plan Description 3 Assurant Health and Welfare Plan Employee Eligibility ......................................................................................5 Eligible Dependents ......................................................................................5 Domestic Partner ...................................................................................6 Social Security Number Requirement ...........................................................7 Proof of Eligibility.........................................................................................7 Electing Coverage and Effective Dates ..........................................................7 Initial Eligibility Period ..........................................................................7 Mid-year Changes ..................................................................................8 Qualified Life Events ....................................................................................9 Limitations ............................................................................................9 Effective Date .......................................................................................10 HIPAA Special Enrollments Rights ..................................................................10 Annual Enrollment ........................................................................................10 Cost of Coverage ..........................................................................................11 Tax Information ............................................................................................12 Non-tax-qualified Dependents ................................................................12 Imputed Income ....................................................................................12 When Coverage Ends ....................................................................................12 When Your Coverage Ends ......................................................................12 When Dependent Coverage Ends ............................................................13 Rescission of Coverage ...........................................................................13 2019 Summary Plan Description 4 Assurant Health and Welfare Plan Employee Eligibility You are eligible to participate in the Assurant Health and Welfare Plan if you are classified by Assurant as: • An active, full time employee. • An active, part time employee regularly scheduled to work at least 20 hours per week. • A temporary employee who is on Assurant’s payroll and is regularly scheduled to work at least 30 hours per week. You are not eligible to participate if you are: • An employee of a leasing agency. • An independent contractor. • A seasonal employee working annually in a position of limited duration not to exceed five months; or • An employee who is not on the U.S. payroll. Assurant’s classification of a person as an employee or non-employee is conclusive and binding for purposes for benefit eligibility. If, for any reason, a person is reclassified from a non-employee to an employee, that person will not be retroactively eligible for benefits. Instead, benefit eligibility will begin prospectively from the date the reclassification is made. Eligible Dependents You can enroll your eligible dependents in the Health and Dental coverage, and Dependent Life Insurance. A person cannot be covered under the Plan as both an employee and a dependent. Further if you and your spouse/domestic partner are both employees, only one of you can cover any eligible children. Eligible dependents include: For Health and Dental Coverage: • Your lawful spouse or domestic partner (as defined below): • Your children, until the last day of the calendar year in which they turn age 26. • Your children who are mentally or physically disabled and totally dependent upon you for support past age 26.1 • Any child who meets the definition of an eligible dependent and for whom you are required to provide health coverage as the result of a qualified medical child support order and • Children (for example grandchildren claimed as dependents on your federal tax return) through the end of the year in which they turn age 26 who: - Receive more than half of their support from you and/or your spouse or domestic partner. - Have your home as their principal residence and - Are your or your spouse’s/domestic partner’s legal ward. • Eligible children include your own and your spouse’s/domestic partner’s biological and adopted children (including children placed for adoption). For Dependent Life Insurance: • Your lawful spouse or domestic partner; and • Your, your spouse’s/domestic partner’s unmarried children from live birth to age 19, or less than age 26 if a full-time student. • Children include any biological or adopted children, stepchildren and foster children, each of whom must depend on you or your spouse/domestic partner for support and maintenance. A child will be 1 Certification of disability must be submitted to Anthem no later than 31 days after the date your child reaches age 26 and may be required periodically. You can request a certification form from HR Services at 866.324.6513 or [email protected]. 2019 Summary Plan Description 5 Assurant Health and Welfare Plan considered adopted on the date of placement in your home. Children also include any children for whom you or your spouse/domestic partner are the legal guardian, who reside with you on a permanent basis and depend on you or your spouse/domestic partner for support and maintenance. Domestic Partner The definition of a domestic partner varies slightly depending on the benefit
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