2019 Carter's Benefits Guide FINAL-SPREAD PDF
2019 Carter's Benefits Guide FINAL-SPREAD PDF
NO ENROLLMENT
= NO COVERAGE
2019
1
ENROLLMENT
2019 ANNUAL ANNUAL ENROLLMENT FOR 2019
BENEFITS IS NOVEMBER 6-16, 2018
CARTERSBENEFITSCENTER.COM • 855.614.0186
CartersBenefitsCenter.com
coverage
Eligible dependents for medical coverage include your legal spouse
and/or a married or unmarried child (up to age 26)1. You must complete your life event
with the Carter's Benefits Center
When adding a dependent who is not covered today to coverage
no later than:
during Annual Enrollment, you must provide the following documents
Full-time benefits-eligible to the Carter’s Benefits Center by November 30th (or your dependent's
coverage cannot be approved):
• 31 days from the day of the life
event, or
employees must take action • 60 days for birth/adoption/
• Child: copy of birth certificate OR proof of birth for
to have benefits in 2019. 2018 guardianship events
You will need to register for the new benefits website before enrolling.
Be sure to have your Employee ID handy as you will use it and your
date of birth to register. You can locate your Employee ID on your
QUESTIONS?
latest paycheck stub or by logging into Employee Self-Service at
Additional information on plan eligibility and qualified life events can
portal.adp.com. (Registration Code: CARTEROSH-ESS).
The Carter’s Benefits Center is
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be found in the Summary Plan Description (SPD) of The William Carter
Company Welfare Benefit Plan, located at CartersBenefitsCenter.com here to help! Call 855.614.0186
to talk to a benefits specialist
SEE PAGE 25 FOR PREMIUMS (M-F 8am to 8pm EST).
For those who work in Puerto Rico or Hawaii: This guide provides plan information for residents of the continental United States. Plans in Puerto Rico 1
For medical coverage, there is also support for employees who may have an unmarried,
and Hawaii meet state specific guidelines, and details are available at CartersBenefitsCenter.com. Need more information? Just call us at 855.614.0186. incapacitated child who (1) is age 26 and over; (2) is not able to support himself/herself;
and (3) depends on you for support (if the incapacity occurred before age 26).
PLAN OVERVIEW. Amounts shown below are for in-network coverage only. You will pay significantly
more if you go out-of-network, so be sure to check with Anthem before you seek care.
PLANS WORK the Anthem 24/7 Nurse Hotline, and LiveHealth Online virtual visits
Preventive Care
LiveHealth Online
0% 0% 0%
to support your care needs while controlling your out-of-pocket costs • Medical Visit $49 flat rate $49 flat rate $15 Copay
In-network preventive care is • Psychology Visit Varies by provider Varies by provider $30 Copay
covered at 100%, with no deductible. Office Visit: Primary & Convenience Care 30%3 25%3 $30 Copay
Office Visit: Specialist & Urgent Care 30%3 25%3 $40 Copay
variable hour employees who work an average of 30 hours or more per week during their initial 11-month new hire measurement
period or ongoing 12-month measurement period will be offered medical coverage for themselves and their eligible dependents,
and will be offered the opportunity to enroll in a Health Savings Account if they elect the Bronze Medical Plan. 2
The family amount can be any combination of family members, but an individual would never satisfy more than his/her own individual amount.
3
After your deductible has been met.
4
On the Bronze Plan, prescription drugs accumulate to the same deductible and out-of-pocket maximum as medical charges, while the Silver
1
In Georgia, it is called the “Blue Open Access POS network” and in all other states, it is called the “National PPO (BlueCard PPO)”. and Gold Plans have a separate out-of-pocket maximum for prescription drugs.
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...are expecting a new
your health! Keep up-to-date with annual preventive care, understand your
own personal health risks, and make an effort to stay active and eat well!
Enrollment can happen any time during pregnancy or up to 6 months postpartum, and includes those welcoming
a new child by adoption.
The possibility of an accident or a hospital stay is never an easy thing to think about. For a small
amount out of your paycheck, Carter’s provides two plans that offer protection in the form of a lump
Prescription coverage through Express Scripts is included with every Carter's medical sum payment for out-of-pocket expenses if you or your covered dependents experience a qualified
plan. The plan utilizes the Express Scripts National Preferred Formulary, and select accident or hospital stay (i.e. admission) during the plan year.
preventive medications are covered in full by Carter's. Use the Express Scripts mobile
app or visit express-scripts.com/carters to review the formulary, check if your preventive The Accident Expense Plan provides a per-accident cash benefit, up to an annual plan year
medication is covered at 100%, and price medications at retail pharmacies near you. maximum ($1,000 or $3,000), to reimburse employees for expenses they experience for themselves
or their dependents (e.g. Emergency Care, Urgent Care, Fractures, Physical Therapy). Each employee
or spouse on coverage will have up to the maximum annual benefit for qualified expenses, and
dependent reimbursement is capped as one combined benefit for all children on coverage.
The Hospital Indemnity Plan provides a cash payment if you or your covered dependents experience
CARTER’S PROVIDES YOU WITH a qualified hospital admission during the plan year (all claims require a 24-hour minimum stay and
2 OPTIONS FOR FILLING 90-DAY KEEP IN MIND... are limited to one stay per year per covered member). The plan provides a lump sum Daily Hospital
benefit of $1,000 for the 1st day and $100 per day for days 2 through 30. There is also an in-hospital
PRESCRIPTIONS...
Intensive Care Unit (ICU) benefit that provides an additional lump sum benefit of $100 per day for
(for medications you use regularly at a lower out-of-pocket Certain medications require prior a qualifying ICU confinement on days 1 through 30.
cost (vs. a 30-day supply at retail pharmacies)) authorization (PA) from your
physician (to determine medical
necessity or dosing limits). Be
HOME DELIVERY THROUGH SMART 90 sure your doctor works with the
EXPRESS SCRIPTS WALGREENS Express Scripts PA Department
Want more details or to ensure you know what qualifies for coverage? Review
at 800.753.2851.
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the benefit brochures and videos for each plan at CartersBenefitsCenter.com
A 90-day supply of Pick up your 90-day or on the Kemper page at kemperbenefits.com/enrollment/carters
medication, conveniently supply directly from To manage your out-of-pocket
delivered directly to a Walgreens network costs, work with your doctor to
your home. pharmacy. consider a lower-cost option
when beginning a new course
of treatments.
Ask your doctor to submit a 90-day prescription (plus any
NOTE
The underwriting company for the accident expense product is Reserve National Insurance Company, a Kemper Life & Health Company. Kemper Corporation
(NYSE:KMPR) is one of the nation’s leading insurers, with subsidiaries that provide an array of products to the individual and business markets. Kemper
applicable refills), and update automated refills when switching.
underwriting companies are rated “A-” (Excellent) by A.M. Best Company, a leading insurance industry rating authority. Kemper Corporation is not responsible
for the products of any of its underwriting companies. The underwriting company for the hospital indemnity product is Fidelity Security Life Insurance
Company (FSL). FSL is rated “A-” (Excellent) by A.M. Best Company. FSL is not financially affiliated with Kemper Corporation.
GO IN-NETWORK Carter’s offers two Dental plans from MetLife – Basic and Premier –
IN-NETWORK PLAN HIGHLIGHTS INCLUDE:
so you can choose the coverage that’s best for you and your family.
If you compare the plans, the only difference is that the Premier plan
• Low-cost copay for your annual vision exam and contact lens exam (fitting and evaluation)
You can use any qualified provider, offers a higher annual maximum and lifetime orthodontia benefit.
• Comprehensive coverage for frames, lenses, and contacts
but out-of-network providers may • Access to discounts on a variety of lens options and upgrades such as scratch resistance, anti-reflective
bill you for fees in excess of the coatings, and progressives, plus access to refractive (Lasik) surgery discounts from a nationwide network
amounts negotiated by MetLife. DENTAL COVERAGE INCLUDES:
Visit metlife.com/dental (PDP Plus
Network) to review a list of
• Free preventive and diagnostic care, such as routine exams,
MetLife providers.
cleanings, fluoride treatments (for children under age 19), sealants, BENEFIT SUMMARY IN-NETWORK OUT-OF-NETWORK
and x-rays – plus these diagnostic and preventive services do not
count toward your annual benefit max (plan covers 1 preventive Exams (Every 12 Months) Covered In Full After $10 Copay Up To $45 Reimbursement
Consider requesting a pretreatment visit every 6 months)
Standard Lenses Per Pair (Every 12 Months)
estimate from your dental provider to • Basic treatments such as fillings, extractions, root canals, • Single Vision Covered In Full After $25 Copay Up To $30 Reimbursement
help you avoid unexpected costs. oral surgery and gum disease • Bi-Focal Up To $50 Reimbursement
• Major treatments such as crowns, dentures, and orthodontia • Tri-Focal Up To $65 Reimbursement
• Standard Progressive Up to $55 Copay Up To $50 Reimbursement
coverage (for children under age 19)
ACCOUNTS
HSAs and FSAs require re-enrollment every year so be sure
to take action during annual enrollment.
PROTECTION
Business Travel 6x annual base earnings
100% Company Paid
PET
Accident (up to $450,000)
LEARN MORE ABOUT THE LIFE INSURANCE OPTIONS DURING YOUR ENROLLMENT SESSION.
COMMUTER BENEFITS
To help you save money on your commute to work,
you can use pre-tax paycheck deductions to pay for
qualified transit and/or qualified parking expenses
(up to the IRS monthly maximum amount of $260).
You must place your one-time or recurring monthly
order by the 10th of the month for the following
month. All orders placed by the 10th are processed
and mailed by the 23rd.
EMPLOYEE DISCOUNT
All employees are eligible for a generous discount
on purchases made at all Carter's | OshKosh stores,
and may also participate in the Rewarding Moments
program to earn $10 towards a future purchase
for every $100 you spend. Purchases qualifying for
employee discount must be made by you or your
spouse only using your Employee ID.
Carter’s is committed to supporting organizations that promote the health and wellbeing of children through
contributions of time, money, and product. In support of this commitment, the Company has established a variety
of programs to encourage employees to support organizations of their choice. Summaries of these programs are
provided below. Please review the Company policy on the Carter’s intranet for additional details on each program.
MATCHING Carter’s is proud to match 100% of every dollar given by an eligible full-time
employee to charitable organizations that benefit the health and wellbeing
GIFTS
of children, up to $500 per employee per calendar year.
CARTER'S IN THE All eligible full-time U.S. employees who spend 16 hours volunteering at an eligible
school can earn a $250 cash grant from Carter’s for that school. Employees may
CLASSROOM apply for one Carter’s in the Classroom grant per calendar year.
VOLUNTEER Full-time Corporate employees, Distribution Center employees, and Retail District
Managers and above in the field are eligible to receive 16 hours of paid Volunteer
TIME Time each calendar year to support charitable organizations of their choosing.
Please note that manager approval is required before utilizing volunteer time.
The first time you visit the new site, register using your Carter's Employee ID number
NOTE
as your username, and your date of birth following Carter's in the following format:
Carter'sMMDDYYYY. The "C" in Carter's must be capitalized.
QUESTIONS PREMIUMS
You and Carter's share in the cost of medical coverage, with Carter's paying the majority of the cost.
CAN MY DEPENDENT(S) SELECT A DIFFERENT MEDICAL PLAN FROM ME? You will pay $50 per month more for medical coverage if you or any of your covered dependents use
No. You and your dependent(s) must all have the same medical plan. tobacco. You are required to complete a tobacco attestation during your enrollment session.
BENEFIT TIER $1,000 PLAN $3,000 PLAN BENEFIT TIER HOSPITAL INDEMNITY PLAN
Employee Only $4.08 $8.19 Employee Only $4.96
Employee + Spouse $6.94 $13.92 Employee + Spouse $9.92
Employee + Child(ren) $7.75 $15.56 Employee + Child(ren) $9.32
This guide describes the benefit plans available to you as an employee of Carter’s. The benefits material in this guide is provided as a convenience.
Every effort has been made to ensure the accuracy of this material, however, more detailed information about coverage and/or benefits specific Employee + Family $10.20 $20.48 Employee + Family $14.28
to you, based on your employee group, is available in the Summary Plan Description (SPD) for The William Carter Company Welfare Benefit Plan
(the “Plan”), our overall benefit program, as well as specific SPDs for each of the individual benefit programs under the Plan and should serve as
your primary resource for benefit information. Additional information regarding Company policies that are not referenced in the SPDs may also
be found in the Company's Employee Success Guide or HR Policy documents. If you are not clear about the benefits available to you, contact Additional benefit premiums not shown in the guide will be
a member of the Human Resources team. In the event the information in this guide differs from the official Company documents, the official available during your enrollment session.
Company documents will control (Plan or Policy documents). Additionally, if the premium rates in this guide differ from the rates in the Carter’s
Benefits Center enrollment system, the enrollment system will control. Carter’s reserves the right to amend or terminate the plan(s) or program(s)
at any time. This guide does not constitute a contract and participation in any of the benefit plans does not guarantee employment.
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2019 CONTACTS
401(k) Merrill Lynch Healthcare Bluebook Maven
800.228.4015 800.341.0504 [email protected]
benefits.ml.com healthcarebluebook.com/cc/carters mavenclinic.com/carters
Mobile app Company Code: CRI
529 College Savings Plan Medical Plan: Anthem
877.424.4377 Hospital Indemnity Plan: Kemper 855.405.3984
path2college529.com 877.851.0890 anthem.com
kemperbenefits.com
Accident Expense Plan: Kemper MetLife Dental
877.851.0890 Identity Theft Protection: 800.438.6388
kemperbenefits.com ID Watchdog metlife.com/dental
866.513.1518
Back-Up Dependent Care idwatchdog.com MetLife Vision
877.242.2737 855.638.3931
CartersBenefitsCenter.com Legal Plan: MetLaw metlife.com/vision
Username: Carter’s 800.821.6400
Password: Carter’s info.legalplans.com Nationwide Pet Insurance
Access Code: Legal 877.738.7874
Best Doctors CartersBenefitsCenter.com
866.904.0910 LiveHealth Online
members.bestdoctors.com 855.603.7985 Prescription Plan:
livehealthonline.com Express Scripts
Carter’s Benefits Center 855.812.5193
855.614.0186 LOA/STD/LTD: Matrix express-scripts.com
CartersBenefitsCenter.com 877.202.0055
matrixabsence.com Tobacco Cessation Program
Connect Your Care
2018: 877.252.8410
877.292.4040
Matching Gifts and Volunteer 2019: 888.548.3432
connectyourcare.com
Time Program
Employee Assistance Program carters.benevity.org
844.640.WELL (9355)
rsli.acieap.com
APPS
Access helpful tools to get what you need on the go – with
just a few clicks! Get access to doctor locations, pharmacy
reminders, claims status, virtual ID cards, and so much more.
NOW YOU CAN ENROLL IN BENEFITS ONLINE THROUGH THE MYCHOICE APP:
1. Download MyChoice from the Apple iTunes Store or the Android Play store.
2. Log into your account at CartersBenefitsCenter.com to get an access code.
3. Enter the access code in the MyChoice app and start exploring!
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