employee benefits guide · prescription drug coverage with rxbenefits ca times is pleased to...
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EMPLOYEE BENEFITS GUIDEJanuary 1, 2021 – December 31, 2021
BENEFIT OPTIONS THAT FIT YOUR LIFE!
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Benefits Portal SearchableQuickly find service
contact information and
online resources
Benefit PlansReview benefit plan
design information and
find online provider
directories
Group InformationAccess and print
generic ID cards with
group information
How to EnrollFind information on who
is eligible and how to
enroll
iPhoneQR CodeTake Picture
Tap the Share Icon
Add to Home Screen
Android
Tap the Icon in Menu
Select: Add to Home Screen
Nothing to install! Access from a computer, tablet or smartphone.
1) Visit catimes.mybenefitsapp.com
2) Or, scan QR Code to launch app
Benefits at your Fingertips
anaheimarena.mybenefitsapp.com
Our employees are our most valuable resource, and your health and welfare will always be a main
priority of ours. As part of our ongoing commitment to your good health and financial security, we
are pleased to offer flexible benefits to our eligible employees and their family members to help
address their health and welfare needs. Please take time to review this guide and share with your
dependents; we want you to make the right choice for you and your family.
We understand that electing benefits is an important process, we hope you will leverage the
available resources to make the plan selection that best suits the needs of you and your family.
For more information, please contact Empyrean, the CA Times Benefits Department, or visit your
Employee Benefits Portal at catimes.mybenefitsapp.com
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Welcome
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Employee Eligibility / Dependent Eligibility
If you are a regular full-time or part-time employee
regularly scheduled to work at least 30 hours per week, you
and your eligible dependents may participate in the
benefits program. Your eligible dependents include:
• Legally married spouse or domestic partner;
• A natural child, step-child, adopted child, legal
guardianship, children of your spouse or domestic
partner up to age 26;
• A child over the age of 26 that has a severe physical or
mental condition that makes them indefinitely
dependent on you for primary support.
Qualifying Events
If you fail to enroll or make changes during your first 31
days of employment or during open enrollment, you can
only make certain changes to your benefits if you
experience a qualified life event pursuant to the IRS
Section 125 rules. You must report any qualifying life event
to Empyrean within 31 days of the occurrence of the event
to be allowed to make a change. Examples of qualified
life events include:
• Marriage or divorce;
• Spouse or dependent child terminates employment
or becomes employed;
• Birth or adoption of a child;
• Death of a spouse or child;
• Become eligible for assistance under a Medicaid
plan, State Exchange Plan or Medicare
Required Documentation for Dependent Verification
If you are adding a dependent to any CA Times benefit plans, you will be required to submit
dependent eligibility documentation no later than December 31, 2020 directly to Empyrean. Your
dependents will not be enrolled into the plans if required documentation is failed to be to be submitted
within the required deadline and will have to wait until the next open enrollment to enroll into the plans.
All required documents must indicate the date, your name, your Employee ID and your dependent’s
name. This documentation allows us to ensure that only eligible dependents are added to the CA
Times benefit plans.
If you have any questions, you may contact the CA Times Benefits Service Center at (833) 269-2137
from 8am to 5pm PST, Monday through Friday or find Required Dependent Documentation details by
visiting catimes.mybenefitsapp.com, under Eligibility tile.
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You can enroll, waive or make changes to your benefits via Empyrean site starting Monday,
October 26 through Friday, November 6, 2020. The elections you make will stay in effect from January 1, 2021 through December 31, 2021. Dependent verification documents are due to
Empyrean no later than December 31, 2020 for any new dependent(s) being added to the
benefit plans. If no action is taken during this upcoming open enrollment, your current benefits
will rollover into 2021 Plan Year, except for the FSA plans and HSA. Reminder, you must actively
re-enroll yearly into the Health Care FSA, Dependent Care FSA, Health Savings Account (HSA) and Parking / Transit benefit, failing to re-enroll will waive your coverage for 2021.
How to Enroll
Login starting
October 26th
https://compass.empyreanbenefits.com/CATimes
If you are a new user, you must register first. User ID is your company email address.
If you are a returning employee login using your previous
password.
If you experience technical issues, reach out to Empyrean
directly at: (833) 269-2137
Review and confirm all your election no later than November 6th. Make sure
to finish your enrollment until you receive a confirmation. Elections are NOT recorded if you fail to complete
the enrollment in its entirety.
Remember to Submit Dependent Verification by 12/31/2020.
Evidence of Insurability (EOI) must be submitted for new Life or Long Term
Disability enrollments. Coverage is not effective until after the date the
required documents are submitted and approved by the carriers.
You also have the option to make your elections or changes
over the phone by calling CA Times Benefits Service Center administered by Empyrean at
1(833) 269-2137
They are available from 8am to 5pm PST
Monday to Friday
https://compass.empyreanbenefits.com/CATimes
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Contacts
Refer to this list when you need to contact one of your benefit vendors. For general information,
contact your CA Times Benefits Department.
Your Employee Benefits Portal catimes.mybenefitsapp.com
Carrier / Vendor Group # Phone # Website
CA Times Benefits Department N/A (213) 237-2165 Email: [email protected]
Empyrean –Enrollment Administrator
N/A (833) 269-2137 https://compass.empyreanbenefits.com/CATimes
Collective Health Medical PPO / HDHP
282016 (833) 440-4367New Member: join.collectivehealth.com/catimes
Members: join.collectivehealth.com/catimes
Delta Dental
19876-00001
Standard(800) 765-6003 www.deltadentalins.com
19876-00002
Enhanced
Discovery Benefits - FSA 33535 (866) 451-3399www.discoverybenefits.com
Employee Discounts EHJ6XN (866) 664-4621catimes.benefithub.com
Referral Code: EHJ6XN
EyeMed - Vision
1019531-1001
Standard(866) 299-1358 www.eyemed.com
1019531-1002
Enhanced
Health Equity - HSA N/A (866) 346-5800www.healthequity.com
Kaiser PermanenteMedica HMO
Northern CA
Region: 606131(800) 464-4000 www.kp.org
Southern CA
Region: 234268
LegalZoom - LifePlan N/A (855) 787-1909www.lifeplan.legalzoom.com
LifeLock - Identity Theft Protection YIG480 (800) 607-9174 www.lifelock.com
Lincoln Financial GroupShort Term Disability
Long Term Disability
000010247437
STD(800) 423-2765 www.lfg.com
000010247436
LTD
ComPsych Employee Assistance Program
California Times (855) 327-4463www.GuidanceResources.com
Web ID: Lincoln
MetLife Legal Plan 217517 (800) 821-6400 www.legalplans.com
MetLife - Voluntary Products 217517 (800) 438-6388 www.metlife.com
Nationwide - Pet Insurance N/A (877) 738-7874 www.petinsurance.com/catimes
Telemedicine N/A(888) 548-3432 www.livehealthonline.com
(866) 454-8855 www.kp.org
Vanguard - 401(k) / DCRP 094880 / 094625 (800) 523-1188 www.vanguard.com/actnow
WageWorks - Commuter Benefit CA Times (877) 924-3967 www.wageworks.com
tel:213-237-2165tel:833-269-2137https://compass.empyreanbenefits.com/CATimestel:833-440-4367http://join.collectivehealth.com/catimeshttp://join.collectivehealth.com/catimestel:800-765-6003http://www.deltadentalins.com/http://www.discoverybenefits.com/mailto:[email protected]:866-664-4621https://catimes.benefithub.com/tel:866-229-1358http://www.eyemed.com/tel:866-346-5800http://www.healthequity.com/https://catimes.mybenefitsapp.com/contacts/[email protected]:800-464-4000http://www.kp.org/tel:855-787-1909http://www.legalplans.com/mailto:[email protected]:800-607-9174http://www.lifelock.com/tel:800-423-2765https://www.lfg.com/tel:833-306-0099http://www.guidanceresources.com/tel:800-821-6400http://www.legalplans.com/tel:800-438-6388https://mybenefits.metlife.com/getGroupByIdForHP.htm?group=217517&aURL=http://zzztel:877-738-7874http://www.petinsurance.com/tel:888-548-3432http://www.livehealthonline.com/tel:866-454-8855http://www.kp.org/tel:800-523-1188http://www.vanguard.com/tel:877-924-3967
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Medical Plans with Collective Health (Anthem Blue Cross Network)
You have the option of two plans through Collective Health, a PPO and HDHP. Employees may seek services
from in-network and out-of-network providers. Utilizing an in-network provider offers an enriched benefit; a
lower deductible, a lower co-insurance charge, and expenses over the usual and customary limit are waived.
If an out-of-network provider is selected, the employee may be responsible for charges above the usual and
customary limit. Benefits are paid on covered charges after the deductible is satisfied on certain services under
the PPO plan. Under the HDHP the full deductible must be satisfied first for all services before benefits are paid.
Coverage out of the country are only covered in emergency situations.
Please take time to review the chart below; we want you to make the right choice for you and your family. This
chart is a brief summary only. In the event of discrepancy, plan documents will prevail. Certain limitations and
exclusions apply. For exact terms and conditions, please refer to the summary plan description located within
catimes.mybenefitsapp.com.
Your Employee Benefits Portal catimes.mybenefitsapp.com
Get to know your plan options at join.collectivehealth.com/catimes
MEDICAL
Collective Health – PPO
(Anthem Blue Cross Network)
Collective Health – HDHP
(Anthem Blue Cross Network)
In-Network Out-of-Network In-Network Out-of-Network
Calendar Year Maximum
Out Of Pocket
(Individual/Family)
$3,000 / $6,000 $6,000 / $12,000 $6,750 / $13,500 $11,400 / $22,800
Calendar Year Deductible
(Individual/Family)$1,000 / $2,000 $3,000 / $6,000 $3,375 / $6,750 $6,750 / $13,500
Preventive Care No Charge* 40% coinsurance No Charge* 40% coinsurance
Primary Care
Specialist Visit
$25 copay*
$40 copay*
40% coinsurance
40% coinsurance
20% coinsurance
20% coinsurance
40% coinsurance
40% coinsurance
Urgent Care 20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance
Diagnostic Lab & X-Rays
Complex Imaging (CT/Pet Scans, MRI’s)
20% coinsurance
20% coinsurance
40% coinsurance
40% coinsurance20% coinsurance 40% coinsurance
Chiropractic
(limit 30 visits/year)20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance
Acupuncture
(limit 12 visits/year)20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance
Emergency Room Care $150 copay/visit* $150 copay/visit* 20% coinsurance 20% coinsurance
Inpatient Hospital 20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance
Outpatient Surgery 20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance
Mental Health &
Substance Abuse
$25 copay office
visit*
40% coinsurance 20% coinsurance 40% coinsurance
*Deductible Waived
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We partner with Collective Health for the
Medical PPO and HDHP plan to empower our
health benefits. They’re here to make using your
benefits easier and more transparent than ever.
Collective Health can help you monitor your
claims, find local doctors, and simply understand
how your benefits work.
Collective Health is here to
help!GIVE THEM A CALL OR EMAIL THEM(833) 440-4367 / [email protected] – Friday 4am to 6pm PST
Saturday 7am to 11am PST
FOR MORE INFORMATION
More information about these and other important tools to help you
manage your health are available
on the Collective Health website:
join.collectivehealth.com/catimes
Benefits info, handled• Easily review your
medical plan
• Get a detailed breakdown
of your benefits
• Find an in-network doctor
Pocket-sized ID cards• Your insurance card
and health benefit info fits
right into your pocket. Just
download the mobile app
Ditch the jargon• They’ve translated the
medical speak into
understandable
language so you can
choose and use your
health benefits with total
clarity
Answers to your questions!• Their help center can
help you navigate your
account, better
understand billing, and
decode complicated
insurance terms
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Prescription Drug Coverage with RxBenefits
CA Times is pleased to announce effective January 1, 2021, your pharmacy benefits for the PPO and HDHP
plan will be administered by RxBenefits in partnership with Express Scripts. All members enrolled in the Collective
Health PPO or HDHP will receive a New member ID with the New Pharmacy Information. You must present the
new card beginning January 1, 2021 when filing a prescription. The RxBenefits service model delivers enhanced
safety, better cost savings, and top-notch customer service. You will continue to have access to a massive
network of more than 60,000 pharmacies nationwide.
Your prescription benefit coverage includes:
Member Services: Dedicated to meeting your prescription benefits needs, RxBenefits can be reached at (800) 334-8134 or [email protected] Monday through Friday from 7am to 8pm CT. After hours you may choose to transfer directly to Express Scripts.
Digital Tools: January 1, 2021 register at express-scripts.com and download the Express Scripts mobile app to manage your profile, request refills, locate pharmacies, and more!
Drug Exclusions: Review the Formulary Exclusions List at express-scripts.com and the Exclusions section in the Prescription Benefit Coverage document. Speak with your doctor about moving to a covered alternative if you are prescribed an excluded medication.
Prior Authorization: Certain medications require Prior Authorization (PA) before the prescription can be filled. The PA review process helps ensure FDA prescribing guidelines are met and that you receive the safest and most appropriate drug therapy.
Maintenance Medications: Treat ongoing conditions like diabetes, high blood pressure, and asthma. In addition to local retail pharmacy access, your benefit coverage allows medications to be filled by mail.
Pharmacy
RxBenefits – PPO
(Express Scripts Network)
RxBenefits - HDHP
(Express Scripts Network)
In-Network Out-of-Network In-Network Out-of-Network
Retail Pharmacy
(30-Day Supply)
Generic Drugs$10 copay $10 copay 20% coinsurance Not Covered
Preferred Brand Drugs
(Min. $25, Max $50 copay)30% coinsurance 30% coinsurance 20% coinsurance Not Covered
Non-Preferred Brand Drugs
(Min. $40, Max $80 copay)45% coinsurance 45% coinsurance 20% coinsurance Not Covered
Specialty Drugs$125 copay Not Covered 50% coinsurance Not Covered
Mail Order Pharmacy
(90-Day Supply)
Generic Drugs$10 copay Not Covered 20% coinsurance Not Covered
Preferred Brand Drugs$100 copay Not Covered 20% coinsurance Not Covered
Non-Preferred Brand Drugs$160 copay Not Covered 20% coinsurance Not Covered
Specialty Drugs$125 copay Not Covered 50% coinsurance Not Covered
mailto:[email protected]
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Medical Plans with Kaiser
You have the option of two plans through Kaiser Permanente, Traditional HMO and Signature (Deductible)
HMO plans. Kaiser is an HMO plan with a closed network of providers. The HMO plan is designed for you to
choose a primary care physician from Kaiser’s network.
The Traditional HMO plan covers the cost of services only when authorized with simple copays and
coinsurance and no annual deductible applies. Through the Signature (Deductible) HMO plan, you
receive the quality care and service you expect from Kaiser Permanente. You will pay the full charges for
some services until you reach your deductible. After you reach your deductible you’ll start paying less – a
copay or a percentage of the charges (coinsurance) for the rest of the plan year.
Please take time to review the chart below; we want you to make the right choice for you and your
family. This chart is a brief summary only. In the event of discrepancy, plan documents will prevail. Certain
limitations and exclusions apply. For exact terms and conditions, please refer to the summary plan
description located within catimes.mybenefitsapp.com.
Your Employee Benefits Portal catimes.mybenefitsapp.com
MEDICAL
Kaiser Permanente
Traditional HMO
Kaiser Permanente
Signature (Deductible) HMO
In-Network* In-Network
Calendar Year Maximum Out
Of Pocket (Individual/Family)$500 / $1,000 $3,000 / $6,000
Calendar Year Deductible
(Individual/Family)None $1,000 / $2,000
Preventive Care No Charge No Charge
Primary Care
Specialist Visit
$15 copay
$25 copay
$25 copay*
$40 copay *
Urgent Care $15 copay $25 copay*
Diagnostic Lab & X-Rays
Complex Imaging (CT/Pet Scans, MRI’s)
No Charge
No Charge20% coinsurance
20% coinsurance
Chiropractic
(limit 30 visits/year)$15 copay $15 copay*
Acupuncture
(limit 30 visits/year)$15 copay $15 copay*
Emergency Room Services $50 copay $150 copay
Inpatient Hospital $125 copay 20% coinsurance
Outpatient Surgery $50 copay 20% coinsurance
Mental Health &
Substance Abuse$15 copay $25 copay*
Pharmacy
Generic Drugs
Retail (up to 30-day supply)
Mail Order (up to 100-day supply)
$5 copay
$10 copay
$10 copay*
$10 copay*
Brand Drugs
Retail (up to 30-day supply)
Mail Order (up to 100-day supply)
$10 copay
$20 copay
30% coinsurance (up to $50)*
30% coinsurance (up to $50)*
Specialty Drugs
Retail (up to 30-day supply) $10 copay $125 copay*
*Deductible Waived
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2021 Plan Year - Virtual Medical Visits and Mental Health Benefits
Do you have an ear infection, pink eye, suffering from anxiety, depression or another health issue that needs to
be addressed? If you need non-emergency medical attention, virtual medical visits might be a solution. You
can have a doctor’s appointment from the comfort of your home.
24/7 Nurse
Nurseline gives you access to a registered nurse 24 hours a day, seven days a week. Use this free service to have your
non-emergency questions answered.
Collective Health PPO and HDHP Plan Members Call (800) 700-9186 to receive assistance with any health-related questions or concerns.
Kaiser HMO Plan Members Call (833) 574-2273 to receive assistance with any health-related questions or concerns.
Collective
Health PPO
Members
(In-Network)
Telemedicine Visits With Your Own Provider
• Primary Care Doctor - $25 copay
• Specialist - $40 copay
• Mental Health Visits - $25 copay
LiveHealth Online – livehealthonline.com
You have access 24/7 by web, phone or mobile
app to medical providers and licensed therapist
$10 copay
Collective Health
HDHP Members
(In-Network Only)Deductible Applies
Telemedicine Visits With Your Own Provider
• Primary Care Doctor - 20% after deductible
• Specialist - $20% after deductible• Mental Health Visits - 20% after deductible
LiveHealth Online – livehealthonline.com
You have access 24/7 by web, phone or mobile
app to medical providers and licensed therapist 20% after deductible
Kaiser HMO
MembersSee plan document
for coverage level
See physicians and providers for urgent health
concerns by video visit. Register at kp.org today
to schedule a video visit. You can use the
telemedicine service available through kp.org or
by calling (866) 454-8855.
See physicians and providers for urgent health
concerns by video visit. Register at kp.org today
to schedule a video visit. You can use the
telemedicine service available through kp.org
or by calling (866) 454-8855.
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This plan allows you to select the dentist of your choice. Both you and Delta Dental have a shared responsibility of
paying the dentist for services rendered. If you choose a dentist who participates in the Delta Dental PPO network
claims will be filed on your behalf. Please note: If you select a dentist from the Delta Dental PPO Network, you will
pay less in out-of-pocket expenses.
Dental Plans with Delta Dental
Delta Dental Dental PPO – Standard Plan Dental PPO – Enhanced Plan
Plan Feature In-Network Out-of-Network In-Network Out-of-Network
Calendar Year Maximum
Per Person $1,500 $1,500 $2,000 $2,000
Calendar Year Deductible
Per Individual
Per Family
$50 copay
$150 copay$50 copay
$150 copay
Preventive Services
(Exams and cleanings, x-rays)You pay 0% You pay 0%
Basic Services You pay 20% after plan deductible You pay 20% after plan deductible
Major Services You pay 50% after plan deductible You pay 50% after plan deductible
Orthodontic Not Covered You pay 50%
Orthodontic Lifetime Max N/A $2,500 per person
Orthodontic Eligibility N/A Children Only (up to age 19)
Your Employee Benefits Portal catimes.mybenefitsapp.com
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Vision Plan with EyeMed
EyeMed offers a large network of contracting providers, including optometrists and ophthalmologists. When a
contracting network provider is used, the care is considered “in-network” and the out-of-pocket costs will be
less, and the highest level of benefits is received. If a provider outside the network is used, the care is
considered “out-of-network” coverage is still provided, but the out-of-pocket costs will be significantly higher.
Your Employee Benefits Portal catimes.mybenefitsapp.com
Plan Feature
EyeMed Vision Plan
Standard Plan Enhanced Plan
In-NetworkOut-of-Network
ReimbursementIn-Network
Out-of-Network
Reimbursement
Copay
• Examination (Every 12 Months)
• Materials
$10 copay
$25 copay
Up to $40
Up to $40-$60
$10 copay
$10 copay
Up to $40
Up to $40-$60
Frames Standard Plan (Every 24 Months)
Enhanced Plan (Every 12 Months)
$130 allowance
+ 20% off
balance
Up to $45
$175
allowance
+ 20% off
balance
Up to $45
Elective Contact Lenses
(Every 12 Months)
In-Lieu of Frames and Lenses
$130 allowance Up to $105 $175 allowance Up to $105
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Life Plan – LegalZoom LifePlan
LegalZoomTM LifePlan is a different kind of support, based
around your life. When questions arise surrounding important
events—getting married, buying a home, having a baby—
reach out to LegalZoom LifePlan for advice and direction.
From planning for your future, to getting help with your taxes,
LifePlan is your go-to resource. This plan also includes Identity
Theft protection.
What You Get• Legal, Insurance, Financial
and Tax Advice Sessions
• Identity Theft Protection
(One-Bureau Credit
Monitoring, Full Service
Restoration, ID Theft
Insurance)
• Unlimited File Storage in Our
Digital Vault
• Attorney Consulted Legal
Library• Document Review
• 10% Off Over 40
Comprehensive Products &
Services
Ease of Use
• Advice sessions can be
scheduled through the
mobile app, website, or
with a call to a Membership
Advisor
• Members are able to see
real time attorney
availability, ratings, reviews,
and online bios
• Estate planning documents
can be completed through an easy to use online
platform
• Membership Advisors are
there for you M-F
5am - 5pm PST
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Flexible Spending Accounts (FSAs) and Health Savings Account (HSA)
You are offered Flexible Spending Accounts (FSAs) through Discovery Benefits a Health Savings Account (HSA-
only available for HDHP members) through Health Equity, and a Commuter Benefit through WageWorks, these
plans allow you to contribute on a pre-tax basis to pay for qualified expenses. Please review the below for a
comparison of the different types of tax-advantages of these accounts.
Please refer to catimes.mybenefitsapp.com for a more detailed HSA and FSA Information Guide, qualified expenses list and claim forms.
Ful l Purpose
Health Care
FSA
You can contribute up to $2,750* each year
(minimum of $100*) to pay for eligible medical,
dental, and vision expenses incurred by you and your
family during the plan year.
As of this year you can carryover up to $550* of
unused healthcare FSA funds at the end of the plan
year to use for the following plan year. This will not
count against your 2021 IRS maximum contribution.
The funds you elect are available to you from the
start of the plan year.
Current 2020 health care FSA plan year members
have until 12/31/2020 to incur claims, any amounts
below $100 or over $550 leftover beginning 1/1/2021
will be forfeited. Claims for reimbursement must be
submitted by 3/31/2021 for qualified expenses
incurred prior to 12/31/2020.
Limited Purpose
Health Care FSA
When enrolled in the High Deductible Health Plan
(HDHP) and a Health Savings Account (HSA) you may
also elect a Limited Purpose FSA (LPFSA) concurrently,
allowing you to receive reimbursement for eligible
dental and vision expenses only.
If enrolled in the HDHP, but not an HSA, you may enroll
in the Full Purpose Healthcare FSA with access to all
eligible medical, dental, and vision reimbursements.
Same limits as above apply for LPFSA.*
The funds you elect are available to you from the
start of the plan year.
Current 2020 plan year members have until
12/31/2020 to incur claims, any amounts below $100
or over $550 leftover beginning 1/1/2021 will be
forfeited. Claims for reimbursement must be
submitted by 3/31/2021 for qualified expenses
incurred prior to 12/31/2020.
Dependent
Care FSA
You can contribute up to $5,000 each year on a pre-
tax basis to pay for day care expenses for your
eligible dependents. This limit will be reduced to
$2,500 if you are married and filing separate tax
returns. For spouses who both contribute to DFSA, the
max amount that can be contributed between both
accounts is $5,000.
The funds available in your account will be the
amount deducted from your paycheck at that point
in time, the full amount is not available from the start
of the plan year.
Qualified dependent care expenses must all be
incurred by 12/31 each year. Any remaining balances
will be forfeited. You will have until 3/31/2021 to
submit your claims for reimbursement for qualified
dependent care expenses incurred prior to
12/31/2020. There is no carryover of unused
Dependent Care FSA funds.
Health Savings
Account
(only available to
HDHP members)
If you enroll into the HDHP health plan you can
contribute up to $3,600 for a single and $7,200 for a
family* each year to pay for eligible qualified health
care expenses incurred by you and your family. If you
are age 55 and over you have an additional catch-
up contribution of up to $1,000 per year (until you
enroll in Medicare)
The funds available will be the amount deducted
from your paycheck at that point in time, the full
amount is not available from the start of the plan
year.
HSA funds are yours for life, you maintain ownership of
the account even after you leave the company or
retire.
Commuter
Benefit
A WageWorks Commuter program is a pre-tax benefit
that can save you on parking and public transit-that
includes train, subway, busy and eligible vanpool as
part of your daily commute to work.
You can contribute up to $270 pre-tax for public
transit per month and CA Times subsidizes up to $70
monthly. You can also contribute up to $270 pre-tax
for parking as part of your daily commute to work.
Your Employee Benefits Portal catimes.mybenefitsapp.com
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Flexible Spending Accounts (FSAs) and Health Savings Account (HSA)
Downloaded the free Benefits Mobile App by Discovery
Benefits yet?
If you have the Health Care FSA or Dependent Care FSA,
the Benefits Mobile App lets you:
•Easily log in with Touch ID
•Check your balance anytime, anywhere
•Take a photo of documentation to submit a claim
•Track expenses
•Get claim alerts
•And more!
Download the app today by searching for "Discovery
Benefits" in the Apple or Android app store and manage
your benefits information directly from your mobile device.
If you enrolled in the Collective Health HDHP and chose to fund an HSA
through Health Equity, download the free Benefits Mobile App.
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Life and Accidental Death & Dismemberment (AD&D)
Your Employee Benefits Portal catimes.mybenefitsapp.com
Basic Life/AD&D - Company Paid
CA Times provides you with Basic Term Life and AD&D insurance coverage in the amount of 1 times
your base annual earnings to a maximum of $1,000,000.
Voluntary Life - Employee Paid
You may elect 1 to 8 times your basic annual earnings of Voluntary Life insurance for yourself, to a
maximum of $2,000,000. The guarantee issue is the lesser of 3 times your annual salary up to
$650,000.
For your spouse/ registered domestic partner you may elect Voluntary Life options of $10,000,
$25,000, $50,000, $100,000, $150,000 or $250,000, up to 100% of your coverage amount. The
guarantee issue is up to $25,000.
For your dependent child(ren) you may elect $5,000, $10,000 or $25,000. The guarantee issue is up
to $25,000.
Guarantee Issue amount is only available for new hires. Any new enrollments or increases to life
insurance will require an Evidence of Insurability(EOI).
Voluntary AD&D Plan – MetLife
Voluntary AD&D - Employee Paid
You may elect $25,000 to $2,000,000 of AD&D coverage in increments of $25,000. The maximum
amount of coverage you can receive is the lesser of 10 times your basic annual earnings or $2,000,000.
For spouse/registered domestic partner coverage only, you may elect 50% of your coverage amount,
not to exceed $1,000,000.
For child(ren) only, you may elect up to 15% of your coverage amount, not to exceed $300,000.
For your spouse/registered domestic partner and child(ren) coverage together, you may elect an
amount equal to 40% for your spouse/registered domestic partner only, and 10% for each child, of your
Voluntary AD&D coverage.
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Critical Illness, Accident and Hospital
Your Employee Benefits Portal catimes.mybenefitsapp.com
Critical IllnessThe Critical Illness Insurance through MetLife will help pay
you a percentage of the maximum coverage you choose.
Diagnosed illnesses like heart attack, stroke, Alzheimer’s
disease and cancer are among those covered. Rates will
vary, as they are based on age, smoker status and family
size. Critical Illness insurance will compliment your medical
and disability income coverage, which can ease the
financial impact of certain critical illnesses.
AccidentWith MetLife Accident Insurance, you have a choice of two
comprehensive plans a Low Plan and High Plan,
which pays money based on the injury or treatment
you and/or your eligible dependents receive, whether it’s a
simple sprain or something more serious, like an injury from
a car accident. The Low and High Plans may pay you
and/or your dependents a benefit for an emergency room
treatment, stitches, crutches, injury-related surgery and
certain other accident-related expenses.
HospitalYou are offered two Voluntary Hospital Indemnity Insurance
Plans through MetLife for you and your eligible family
members. It can complement your medical coverage by
helping to ease the financial impact of a hospitalization. A
flat amount may be paid for hospital admission and a per
day amount may be paid for each day of a covered
hospital stay, from the very first day of your stay.
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Supplemental
coverage:
You can elect
to purchase
these additional
benefits as a
new hire, or
during your
annual benefits
enrollment
period
What it is What it could provide
Additional Benefits – Please refer to catimes.mybenefitsapp.com for more details on each benefit listed.
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Supplemental
coverage:
You can elect
to purchase
these additional
benefits as a
new hire, or
during your
annual benefits
enrollment
period
Core Coverage: The company
provides these
additional
insurance benefits
automatically at no
cost to you.
Lincoln
Financial Short-Term
Disability
Pays a percentage of your income for
up to 26 weeks due to injury, illness,
surgery or recovery from childbirth.
60% of weekly salary up to a weekly maximum of $2,308.
ComPsych
Employee
Assistance
Program
Assistance program that offers unlimited
free and confidential counseling
services to employees and their families
for personal and/or work-related
problems.
Support for navigating life issues
like stress, anxiety, depression,
financial, grief and so much more.
Call (855) 327-4463 or visit
guidanceresource.com
Web ID= Lincoln
Chubb
Business
Travel
Accident
All employees, volunteers and students
have access to the company’s
International Advantage® Executive
Assistance® Services through Chubb.
This plan offers trip planning, travel
assistance, emergency response
services, travel alerts, security
services and so much more.
To register visit:
www.chubbtravelapp.com
Policy #PHFD42232646 002
BenefitHub
Provides you with a wide variety of
consumer products and services at a
discounted rate.
Discounts on sporting events,
shopping, theme parks, movies,
travel and more.
Visit: catimes.benefitshub.com
Supplemental
Coverage:
You can elect to
purchase these
additional benefits as a
new hire, or during your
annual benefits
enrollment period.
Lincoln
Financial
Long-Term
Disability
Pays a percentage of your monthly
income up to age 65 or SSNRA for
illness or accident in which you are
unable to work for an extended period
of time.
60% of monthly up to a maximum
of $15,000.
MetLife
Legal Plan
Benefit provides support surrounding
legal matters.
Plan offers you convenient,
professional legal counsel,
which entitles you to receive legal
advice and representation
for covered personal legal
services.
LifeLock
Identity Theft
ProtectionThis plan monitors your identity.
When activity occurs involving
your information, you’re alerted
by email, text, or a phone call.
You can respond to confirm
whether the activity is
legitimate, and if it’s not, a U.S.
based LifeLock Identity
Restoration Specialist will help
you resolve the issue.
MetLife
Auto & Home
Home and auto insurance generous
discounts.
Policies for auto, home, renters
insurance, motorhome and
includes things like towing,
windshield repair and more.
Nationwide
Pet Insurance
Nationwide® provides coverage for
veterinary expenses related to
accidents and illnesses.
Policies are available for dogs,
cats, birds, reptiles and other exotic
pets.
http://www.chubbtravelapp.com/
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Employee Contributions for 2021 Plan Year
CA Times is proud to provide you with competitive benefits and the ability to choose the coverage that meets your
needs. Your cost for coverage will vary depending on the option and level of coverage you choose. The contributions
below are based on 26 pay periods. These are the amounts that will be deducted per paycheck for the plan year of
1/1/2021 – 12/31/2021.
If you are a commissioned employee, please note your medical premiums will adjust according to your Annual
Benefits Base Rate (“ABBR”). This is defined as your base salary + commissions earned in 2020 Fiscal Year (12/30/2019 –
12/27/2020). Medical premiums are based on salary bands, above $100,000 and below $100,000. Please note
deductions will adjust no later than the first paycheck in February 2021.
Medical Employees Making Less Than $100,000
Collective Health | PPO Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $70.00 $207.00 $183.00 $315.00
Collective Health | HDHP Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $32.00 $101.00 $90.00 $157.00
Kaiser Traditional | HMO (CA Only) Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $77.00 $203.00 $179.00 $298.00
Kaiser Signature | HMO (CA Only) Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $39.00 $121.00 $109.00 $185.00
Kaiser Signature | HMO (Mid-Atlantic Only) Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $39.00 $121.00 $109.00 $185.00
Medical Employees Making More Than $100,000
Collective Health | PPO Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $88.00 $241.00 $211.00 $361.00
Collective Health | HDHP Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $40.00 $118.00 $104.00 $180.00
Kaiser Traditional | HMO (CA Only) Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $90.00 $230.00 $204.00 $337.00
Kaiser Signature | HMO (CA Only) Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $46.00 $140.00 $127.00 $214.00
Kaiser Signature | HMO (Mid-Atlantic Only) Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $46.00 $140.00 $127.00 $214.00
Dental
Delta Dental | Standard PPO Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $13.26 $26.53 $34.49 $47.75
Delta Dental | Enhanced PPO Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $14.72 $29.44 $38.28 $52.99
Vision
EyeMed | Standard Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $2.27 $4.01 $4.76 $6.85
EyeMed | Enhanced Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Bi-Weekly (26-Pay Periods) $5.38 $9.51 $11.30 $16.09
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Employee Contributions for 2021 Plan YearCA Times is proud to provide you with competitive benefits and the ability to choose the coverage that meets your needs. Your
cost for coverage will vary depending on the option and level of coverage you choose. The contributions below are illustrated
on a monthly basis, deductions are calculated and deducted on a bi-weekly basis.
If you are a commissioned employee, please note your Life Insurance Premiums and Long Term Disability Premiums will adjust
according to your Annual Benefits Base Rate (“ABBR”). This is defined as your base salary + commissions earned in 2020 Fiscal
Year (12/30/2019 – 12/27/2020). Please note deductions will adjust no later than the first paycheck in February 2021.
Disability
Lincoln Financial
Short Term DisabilitySTD
Monthly Rate Per $10 of Weekly
Covered Payroll$0.082
Voluntary Life/AD&D - Monthly Rates Per $1,000 of Coverage
MetLife | Voluntary Life Employee RateSpouse Rate
(based on their age)
Monthly Rate per $1,000 of Coverage
Age < 24 $0.036 $0.042
Age 25 - 29 $0.036 $0.042
Age 30 - 34 $0.040 $0.049
Age 35 - 39 $0.052 $0.067
Age 40 - 44 $0.072 $0.090
Age 45 - 49 $0.109 $0.132
Age 50 - 54 $0.176 $0.209
Age 55 - 59 $0.272 $0.378
Age 60 - 64 $0.474 $0.711
Age 65 - 69 $0.797 $1.216
Age 70+ $1.355 $2.265
Age 75+ $1.355 $2.265
Child(ren) Monthly Rate Per $1,000 of Coverage $0.153
MetLife | Voluntary AD&D Employee Rate Employee + Family
Monthly Rate per $1,000 of Coverage $0.021 $0.028
LegalZoom - Life Plan - Legal and Identity Theft Protection
LegalZoom | Life Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Monthly Rates $13.90 $13.90 $13.90 $13.90
Lincoln Financial
Long Term DisabilityLTD
Monthly Rate Per $100 of
Covered Payroll
Age
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Employee Contributions for 2021 Plan Year
CA Times is proud to provide you with competitive benefits and the ability to choose the coverage that meets your needs. Your
cost for coverage will vary depending on the option and level of coverage you choose. The contributions below are illustrated
on a monthly basis, deductions are calculated and deducted on a bi-weekly basis.
Voluntary Critical Illness Plans
MetLife | Voluntary Critical Illness Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Monthly Rate Per $100
Age < 24 $0.34 $0.59 $0.55 $0.80
Age 25 – 29 $0.35 $0.59 $0.56 $0.80
Age 30 – 34 $0.49 $0.79 $0.70 $1.00
Age 35 - 39 $0.68 $1.06 $0.89 $1.27
Age 40 - 44 $0.98 $1.50 $1.19 $1.71
Age 45 - 49 $1.42 $2.14 $1.63 $2.35
Age 50 - 54 $2.08 $3.09 $2.29 $3.30
Age 55 - 59 $2.85 $4.20 $3.06 $4.41
Age 60 - 64 $3.89 $5.69 $4.10 $5.90
Age 65 - 69 $5.59 $8.14 $5.80 $8.35
Age 70+ $8.39 $12.26 $8.60 $12.47
Voluntary Accident Plans
MetLife | Accident Plan | Low Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Monthly Rates$7.90 $12.15 $14.30 $18.88
MetLife | Accident Plan | High Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Monthly Rates$15.04 $23.31 $27.16 $35.53
Hospital Indemnity Plans
MetLife | Hospital Plan | High Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Monthly Rates $9.45 $15.62 $15.62 $22.50
MetLife | Hospital Plan | Low Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Monthly Rates$11.93 $19.52 $19.52 $28.40
LifeLock - Identify Theft Protection
LifeLock | Identity Theft | Benefit Elite Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Monthly Rates $7.99 $15.98 $13.99 $21.98
LifeLock | Identity Theft | Advantage Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Monthly Rates$15.99 $31.98 $23.99 $39.98
MetLife Legal Plan
MetLife | Legal Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
Monthly Rates $16.50 $16.50 $16.50 $16.50
Nationwide - Pet Insurance
Nationwide | Pet Insurance
Monthly rates vary by state and type of animal. Must call Nationwide directly for a quote, not payroll deducted.
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DISCLAIMER
This 2021 Benefit Guide provides an overview of some of your benefit plan choices. It
is for informational purposes only. It is not intended to be an agreement for continued
employment. Neither is it a legal plan document. This highlights the key features of the
plan. It is intended to be only a summary of the benefits available to you and does
not include all plan rules and details; this is not to be considered a certificate of
coverage. Please refer to your plan documents for complete information and more
detailed explanations as to coverage. If there is a disagreement between this guide and the plan documents, the plan documents will govern.
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Login to Empyrean to Enroll or Make Changes
Starting 10/26 – 11/6
https://compass.empyreanbenefits.com/CATimes
or Call CA Times Benefits Service Center at (833) 269-2137
8am to 5pm PST, Monday to Friday
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