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2015 Benefits Catalog

Whats Inside
Its Your Time to Choose Make It Great! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Who Is Eligible . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
What You Need to Know and Do. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
What Happens if . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Shopping for Your Benets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Medical Plan Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Dental Plan Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Vision Plan Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Tax-Advantaged Savings Accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Health Savings Account (HSA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Health Care Flexible Spending Account (FSA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Health Reimbursement Account (HRA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
How the Accounts Compare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Dependent Care FSA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Commuter Reimbursement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
Income Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Basic Life and AD&D Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
Disability Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Supplemental Life Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Accident Protection Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
AFLAC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
Critical Illness Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Value-Added Benets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Perks and Discounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Employee Assistance Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
ShapeUp CompleteTM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Programs to Help You Live Well. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
How to Enroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Have Questions or Want More Information? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Its Your Time to Choose
Make It Great!
Annual Enrollment: November 17 December 5, 2014
This is your opportunity to make changes and enroll for your 2015 benefits. If you are new to Little Bird, you have
30 days from your start date to enroll.
When it comes to your benefits, only you can decide what is right for you and your family. That is why Little Bird gives
you flexibility and control in choosing the coverage that best fits your needs and those of your family. Specifically, you
have a number of benefit options to choose from, and your school gives you a virtual dollar amount, called Benefit Bucks,
to spend toward the benefits you want.

Use this 2015 Benefits Catalog and your 2015 Benefits Shopping List to shop for your benefits, and then you can
easily purchase and enroll in the ones you want:
 Online through the Little Bird benefits store at www.littlebird.bswift.com
 By phone through the Little Bird Support Center at 1-877-206-5694.

Express
Checkout!
Look for this symbol on the
following pages for key points
you should know or that will
be helpful to you as you shop. 3
Who Is Eligible
Staff who are regularly scheduled to work at least 30 hours per Take Note if You Are Enrolling a Domestic Partner:
week are eligible for benefits. If you are an eligible employee, Domestic partners are not eligible for Flexible Spending
you can enroll your eligible dependents, which include: Accounts (FSAs) under current IRS regulations. In addition,
the tax consequences of a domestic partnership are your
 Spouse: a lawful spouse who is not divorced or legally
responsibility, not Little Birds or its partnered schools.
separated from you
Under the Internal Revenue Code, an employee is not
 Domestic Partner: a person of the same sex with taxed on the value of benefits provided by an employer
whom an exclusive committed relationship exists, to an employees spouse or dependent. However, the
and the relationship meets the specified criteria IRS has ruled that this does not apply to a domestic partner
in the Domestic Partner Affidavit (you must complete for tax purposes. A declaration of common welfare, such
and submit this affidavit, which can be found online as the registration of a domestic partnership, and applying
at www.littlebird.bswift.com) for benefits using a domestic partnership or civil union
 Children: any dependent up to the age of 26 who may have legal and tax implications. You should speak
is one of the following: with legal and/or tax advisors when establishing a domestic
Your natural born child partnership to fully understand these implications.

Your legally adopted child


A child placed with you for adoption
Your stepchild whose primary place of residence
is with you
Other children for whom you are the legal guardian
A child who is the subject of a Qualified Medical Child
Support Order (QMCSO) issued to you
A child as defined above, over the age of 26, who
is mentally or physically handicapped and incapable
of engaging in self-sustaining employment due
to such incapacity

4
What You Need to Know and Do
Take a moment to review this chart to ensure you do not miss out on getting the protection you and your family need in 2015.

If You Are: Actions to Take:


Currently enrolled in medical, dental, vision, You automatically will be enrolled in plans comparable to those you have
or supplemental life insurance and not updating today. This may or may not continue to meet your needs, so be sure to review
your coverage by December 5, 2014 and verify that the 2015 plans are right for your situation.

You need to provide verification of other coverage for 2015, as described


Waiving coverage in 2015
on page 6.

You must provide proof of dependency before December 5, 2014, or your dependents
Adding dependents
will not be enrolled for coverage.

Currently participating in the Health Care and/or You must make new elections for 2015. (Please note: up to $500 of unused
Dependent Care Flexible Spending Accounts (FSAs) 2014 balances will automatically carry over for the Health Care FSA.)

You must enroll within 30 days of your start date. Otherwise you will only
New to Little Bird be enrolled in benefit plans that are 100% paid by your school, such as basic
life insurance and disability coverage.

Questions?
If you have questions about
your benefit options or how
the plans work, refer to the
list of contacts on page 43.
If you have questions about
how to enroll, call the Little
Bird Support Center at
1-877-206-5694, Monday
through Friday, between
9:00 a.m. and 7:00 p.m., EST
(between 8:00 a.m. and
6:00 p.m., CST). 5
What Happens if
I Do Not Enroll by My Deadline? I Want to Make Benefit Changes
If you are a current employee and do not enroll during Annual During the Year?
Enrollment between November 17 and December 5, 2014, Outside of Annual Enrollment or your initial enrollment, the
you will continue to participate in your benefits automatically. only time you may make changes to your health care coverage
However, with the change in insurance carriers, you will and the FSAs during the year is if you have a qualified life
automatically be enrolled in the new plans that are the event, such as marriage, divorce, birth, adoption, etc. Any
most comparable to what you currently have. changes in benefits must be consistent with the event (for
The only exceptions are the Health Care and Dependent example, if you get married, you can add your spouse).
Care Flexible Spending Accounts (FSAs). You must make Changes must be made within 31 days of the event online
new elections for 2015even if you are enrolled currently. at www.littlebird.bswift.com or by calling the Little Bird
(Please note: up to $500 of unused amounts will automatically Support Center at 1-877-206-5694.
carry over for the Health Care FSA.) For your other benefit options, you may enroll at any time
If you are new to Little Bird and do not enroll within 30 days during the year. Simply log on to www.littlebird.bswift.com
of your start date, you will only be enrolled in benefit plans and go to the Springboard tab at the top of your screen.
that are 100% paid by your school, such as basic life insurance
and disability coverage. I Want to Waive Medical Coverage?
If you have medical coverage through your spouses or
partners plan, you can choose to waive coverage; however,
you will be asked to provide proof of coverage from another
source, such as a scanned, emailed copy of your medical
ID card. Email your proof to the Little Bird Support Center
at littlebird@bswift.com.
In this case, you will receive a flat dollar amount for your
Benefit Bucks, as indicated on your 2015 Benefits Shopping
List. You can use this to shop for the other benefits available
to you, such as dental, vision, optional income protection, etc.

6
Shopping for Your Benefits
When it comes to making an important purchase, most If You Spend More Than Your Benefit Bucks
of us like to research our options to determine what meets You will pay the difference in employee contributions.
our budget and needs. The same holds true when shopping This amount is conveniently deducted from your paychecks.
for your Little Bird benefits. Nothing matters more than For some benefits, such as medical, dental, and vision,
making sure you and your family are taken care of, and contributions are taken pre-tax, which means you do not
that is why spending the time now will help ensure you pay taxes on this money. Other benefits, such as supplemental
get the coverage you want and need in 2015. life insurance, are deducted on an after-tax basis.

To help make your benefit purchases, your school provides If You Spend Less Than Your Benefit Bucks
you with a virtual dollar amount, called your Benefit Bucks.
The amount you receive depends on whether you are You will receive the balance in a tax-advantaged account
enrolling yourself or you and your eligible dependents. that you can use toward eligible health care expenses. If you
enroll in a medical plan option with a Health Savings Account
The following pages describe your benefit options. As (HSA), the balance automatically is deposited in your
you review them, refer to your 2015 Benefits Shopping HSA. If you enroll in any other medical option, the balance
List for your Benefits Bucks and plan costs and then automatically is deposited into a Health Reimbursement
use this shopping list as a way to keep track of the Account (HRA). See page 24 for more details on HSAs
benefits you want. and HRAs.

Do Not Be Fooled
by Plan Names
Shopping for benefits is sort
of like choosing a meal. One
option is not necessarily better
than another, so do not pick your
plans by their names. The best
course of action is to fully
understand the ingredients
of each option and then decide
on the plans that best fit your
tastes and needs. 7
Medical Plan Options
Little Bird offers the following seven medical plan options
to choose from: Knowing These Terms
 Comfort HSA Plan Can Be Helpful
 Comfort EPO Select Plan
Annual deductible: The amount you pay out of your own
 Stability HSA Plan pocket before the plan starts to provide benefits. Note that
 Stability EPO Plan there is no annual deductible required for network preventive
care under any of the Little Bird medical plans.
 Stability PPO Plan
Annual out-of-pocket maximum: The most you have to pay
 Tranquility EPO Plan for health care services, after which the plan pays 100% of
 Tranquility HSA Plan eligible expenses for the rest of the year. This protects you
from very high costs.
Empire BlueCross BlueShield is the insurance carrier for
all plan options, which means you have access to their Copay: A fixed dollar amount you pay for a covered health
care service, usually at the time you receive the service. The
network of doctors, hospitals, and other health care providers.1
fixed dollar amount can vary by the type of covered health
In addition, when you enroll for medical coverage, you
care service.
automatically receive:
Coinsurance: The percentage of eligible expenses that the
 Prescription drug benefits, which are described on the plan pays after you meet your annual deductible.
Find a Network following pages.
Network of providers: Doctors, hospitals, dentists, vision
Provider  Eye-only vision benefits, allowing you to receive a vision specialists, and other health care professionals who agree
exam from an in-network eye doctor every 12 months. to participate in a plan at pre-negotiated, discounted rates.
Go to www.empireblue.com (For more comprehensive vision benefits, you have the
or call 1-800-662-5193. option to enroll in a vision plan, as described on page 18.) Primary care physician: A physician who provides primary
or general care, such as a pediatrician, family practitioner, or
Take note! If you live in New York  Preventive care covered at 100% in-network with general internist.
and enroll in the Comfort EPO no copay or deductible required.
Select Plan, you have access to
a unique network of primary care
physicians, called the Blue Priority 1
If you live in New York and enroll in the Comfort EPO Select Plan, you have access to a unique network of primary care physicians, called the Blue Priority network. If you decide
network. If you decide to enroll to enroll in this option and live outside of New York, you have access to the National PPO Blue Card network, similar to any other medical plan.

in this option and live outside of


New York, you have access to the
National PPO Blue Card network,
similar to any other medical plan. 8
How the Medical Plans Work
While there are different levels of benefits available to you under each medical plan option, there are three types of plans:
 Health Savings Account (HSA)
 Exclusive Provider Organization (EPO) and EPO Select
 Preferred Provider Organization (PPO)

To help you make the best choice for you and your family, it is important to understand the key features of each of the
plans and how they work.

HSA EPO EPO SELECT PPO


Provider network Blue Priority network
Empire BlueCross Empire BlueCross Empire BlueCross
if you live in New York;
BlueShield National BlueShield National BlueShield National
otherwise the National
PPO Blue Card network PPO Blue Card network PPO Blue Card network
PPO Blue Card network

Out-of-network Yes
No No Yes
coverage available (Comfort and Stability only)

Primary care provider Not required

Specialist referrals Not required

Permitted tax-deferred Health Savings Account


Compare Your accounts and Limited Purpose
Health Care FSA Health Care FSA Health Care FSA
Health Care Flexible
Medical Plan Options Spending Account (FSA)
Each Little Bird medical plan option
provides a different level of coverage Important: Regardless of the medical plan you choose, you must pre-certify certain procedures (such as inpatient hospital
for a different price tag. Generally, stays or outpatient surgeries) by calling the telephone number on your ID card in advance of the procedure; otherwise, you
the more comprehensive options will have to pay up to a $5,000 precertification penalty.
have a higher price tag. Review
pages 1315 and refer to your
2015 Benefits Shopping List to
see how the coverage and price
tags compare. 9
Learn More about HSAs
When you choose an HSA medical option, you are enrolling Why Consider an HSA, High Deductible
in a high deductible health plan. This means you have a
higher annual deductible that applies to both medical and
Health Plan Option?
prescription drug expenses. You must meet this deductible  Cost: In most instances, an HSA plan will be a less costly
before the plan starts to pay benefits. When you enroll in option for you and your family.
a high deductible health plan, you have the option to open  You Keep the Money: When you leave the school or retire,
a Health Savings Account in which you set aside tax-free
you can take the money with you.
money. You can use the money you contribute to your
HSA to satisfy your deductible and pay for any other  Build Savings: You have the ability to grow a sizeable
eligible health care expenses. See Health Savings Account account over time through tax-free contributions and
on page 21 for details. investments. With an HSA, you generally have a wide
array of investment options from which to choose.
Your three HSA, high deductible health plan options are:
 Tax Savings: Your contributions and distributions are tax
 Comfort HSA free (and also exclude state taxes in CA, AL, and NJ).
 Stability HSA
 Tranquility HSA

With the Comfort and Stability HSAs, you can use any
provider, though you will generally pay less if you use
a network provider.
However, with the Tranquility HSA, you must use network
providers in order to receive benefits; if you use a provider
or facility that is not in the plans network, you are responsible
for the full cost.

10
Learn More about EPOs and PPOs
EPOs PPOs
An EPO only pays benefits when you receive care within There is one PPO option: Stability PPO.
the plans network. Many services are covered at 100%
A PPO pays benefits regardless of whether you use the
after you pay a copay.
plans network. When you visit a network provider, you
However, if you use a provider or facility that is not in typically only pay a copay, which is a flat dollar amount,
the plans network, you are responsible for the full cost for most in-network services.
of services.
If you decide to go outside of the network, you must satisfy
Your four EPO options are: the annual deductible, and the plan pays a percentage of
expenses, called your coinsurance.
 Comfort EPO
 Comfort EPO Select
 Stability EPO
 Tranquility EPO

Important: If you live in New York and enroll in the


Comfort EPO Select Plan, you have access to a unique
network of primary care physicians, called the Blue Priority
network. If you decide to enroll in this option and live outside
of New York, you have access to the National PPO Blue Card
network, similar to any other medical plan.

11
Prescription Drug Coverage
Regardless of which medical plan you enroll in, prescription Retail Pharmacy
drug coverage is automatically included. The benefit levels
You can go to any network retail pharmacy and
vary depending on the medical plan option you choose:
present your medical ID card for up to a 30-day supply.
 If you enroll in a medical plan with an HSA, you must There is no coverage if you go outside of the network.
satisfy the annual deductible for medical before the plan To locate a network retail pharmacy in your area, go to
starts to provide coverage. http://www.empireblue.com/shared/noapplication/f0/s0/t0/
 If you enroll in a medical plan without an HSA, you pw_e199106.pdf or call 1-800-662-5193.
typically do not have to satisfy the annual deductible.
Most options provide 100% coverage after you pay Mail Order
a copay.
If you need maintenance medication for an ongoing medical
After you enroll, you can access your prescription drugs condition, you can use the mail order program for up to a
in two waysretail pharmacy and mail order. 90-day supply. This gives you the convenience of receiving
your prescriptions in the mail at home, and it generally costs
you less than if you use retail. All you need to do is ask your
doctor to provide your prescription for 90 days, plus refills.
Then order your prescriptions online or by phone. You will
receive more details about how from Empire BlueCross
BlueShield after you enroll.
Refer to the charts on pages 1315 to see how prescription
drug coverage compares under each medical plan.

12
How Your Medical Options Compare
The following chart shows how coverage under the Comfort Medical Options compares:

Comfort HSA Plan Comfort EPO Select Plan2


Network Non-Network Network Only2
HSA Feature Yes (see page 21) None
$4,000 individual $4,000 individual $4,500 individual
Annual Deductible $8,000 family $8,000 family $9,000 family
Annual Out-of-Pocket $6,000 individual $9,000 individual $5,900 individual
Maximum $12,000 family $18,000 family $11,800 family
Lifetime Benefit Maximum Unlimited Unlimited Unlimited
AFTER your annual deductible, unless otherwise noted, the plan pays:
Preventive Care 100%, no deductible 50% 100%
100% after $35 copay (visits 1-3);
Primary Care Physician Office Visits 80% 50% then 70% after deductible
100% after $50 copay (visits 1-3);
Specialist Office Visits 80% 50% then 70% after deductible
Diagnostic Tests/Procedures 80% 50% 70% after deductible
Inpatient Hospitalization 80% 50% 70% after deductible
Outpatient Surgery 80% 50% 70% after deductible
100% after $50 copay (visits 1-3);
Urgent Care Center 80% 80% then 70% after deductible
Emergency Room Visits (copay waived if admitted) 80% 80% 70% after deductible
Mental Health and Substance Abuse
Inpatient 80% 50% 70% after deductible
100% after $35 copay (visits 1-3);
Outpatient (in-office) 80% 50% then 70% after deductible
Prescription DrugsRetail (30-day supply)
Tier 1 (lowest-cost options) 100% after $15 copay1 Not covered 100% after $5 copay
Tier 2 (medium-cost options) 100% after $35 copay1 Not covered 50%; you pay $90 min. and $300 max.
Tier 3 (highest-cost options) 100% after $75 copay1 Not covered 50%; you pay $90 min. and $300 max.
Prescription DrugsMail Order (90-day supply)
Tier 1 (lowest-cost options) 100% after $37.50 copay 1
Not covered 100% after $10 copay
Tier 2 (medium-cost options) 100% after $87.50 copay1 Not covered 50%; you pay $180 min. and $600 max.
Tier 3 (highest-cost options) 100% after $187.50 copay1 Not covered 50%; you pay $180 min. and $600 max.
1
 ou must satisfy the annual deductible before the plan starts to pay benefits.
Y
2
If you live in New York, you access the Blue Priority network. If you live outside of New York, you access the National PPO Blue Card network.

13
How Your Medical Options Compare (continued)
The following chart shows how coverage under the Stability Medical Options compares:

Stability HSA Plan Stability EPO Plan Stability PPO Plan


Network Non-Network Network Only Network Non-Network
HSA Feature Yes (see page 21) None None
$2,000 individual $2,000 individual $1,500 individual $1,500 individual $2,000 individual
Annual Deductible $4,000 family $4,000 family $3,000 family $3,000 family $4,000 family
$3,000 individual $5,000 individual $5,000 individual $5,000 individual $6,000 individual
Annual Out-of-Pocket Maximum $6,000 family $10,000 family $10,000 family $10,000 family $12,000 family
Lifetime Benefit Maximum Unlimited Unlimited Unlimited Unlimited Unlimited
AFTER your annual deductible, unless otherwise noted, the plan pays:
Preventive Care 100%, no deductible 70% 100%, no deductible 100%, no deductible 60%
100% after $25 copay, 100% after $25 copay,
Primary Care Physician Office Visits 90% 70% 60%
no deductible no deductible
100% after $40 copay, 100% after $40 copay,
Specialist Office Visits 90% 70% 60%
no deductible no deductible
Office visit copay if part of visit; Office visit copay if part of visit;
Diagnostic Tests/Procedures 90% 70% 60%
otherwise, 80% otherwise, 80%
Inpatient Hospitalization 90% 70% 80% 80% 60%

Outpatient Surgery 90% 70% 80% 80% 60%


100% after $40 copay, 100% after $40 copay, 100% after $40 copay,
Urgent Care Center 90% 90% no deductible no deductible no deductible
Emergency Room Visits 100% after $150 copay, 100% after $150 copay, 100% after $150 copay,
90% 90%
(copay waived if admitted) no deductible no deductible no deductible
Mental Health and Substance Abuse
Inpatient 90% 70% 80% 80% 60%
100% after $25 copay, 100% after $25 copay,
Outpatient (in-office) 90% 70% 60%
no deductible no deductible
Prescription DrugsRetail (30-day supply)
100% after $15 copay, 100% after $15 copay,
Tier 1 (lowest-cost options) $15 copay1 Not covered Not covered
no deductible no deductible
100% after $35 copay, 100% after $35 copay,
Tier 2 (medium-cost options) $35 copay1 Not covered Not covered
no deductible no deductible
100% after $75 copay, 100% after $75 copay,
Tier 3 (highest-cost options) $75 copay1 Not covered no deductible no deductible Not covered
Prescription DrugsMail Order (90-day supply)
100% after $37.50 copay, 100% after $37.50 copay,
Tier 1 (lowest-cost options) $37.50 copay 1
Not covered Not covered
no deductible no deductible
100% after $87.50 copay, 100% after $87.50 copay,
Tier 2 (medium-cost options) $87.50 copay1 Not covered Not covered
no deductible no deductible
100% after $187.50 copay, 100% after $187.50 copay,
Tier 3 (highest-cost options) $187.50 copay1 Not covered no deductible no deductible Not covered
1
You must satisfy the annual deductible before the plan starts to pay benefits.

14
How Your Medical Options Compare (continued)
The following chart shows how coverage under the Tranquility Medical Options compares:

Tranquility EPO Plan Tranquility HSA Plan


Network Only Network Only
HSA Feature None Yes (see page 21)
$2,000 individual
Annual Deductible None $4,000 family
Annual Out-of-Pocket $5,080 individual $2,000 individual
Maximum $12,700 family $4,000 family
Lifetime Benefit Maximum Unlimited Unlimited
AFTER your annual deductible, unless otherwise noted, the plan pays:
Preventive Care 100% 100%

Primary Care Physician Office Visits 100% after $25 copay 100% after deductible

Specialist Office Visits 100% after $40 copay 100% after deductible

Diagnostic Tests/Procedures 100% 100% after deductible

Inpatient Hospitalization 100% after $500 copay 100% after deductible

Outpatient Surgery 100% after $250 copay 100% after deductible

Urgent Care Center 100% after $40 copay 100% after deductible
Emergency Room Visits
100% after $150 copay 100% after deductible
(copay waived if admitted)
Mental Health and Substance Abuse
Inpatient 100% after $500 copay 100% after deductible
Outpatient (in-office) 100% after $25 copay 100% after deductible
Prescription DrugsRetail (30-day supply)
Tier 1 (lowest-cost options) 100% after $15 copay 100% after deductible
Tier 2 (medium-cost options) 100% after $35 copay 100% after deductible
Tier 3 (highest-cost options) 100% after $75 copay 100% after deductible
Prescription DrugsMail Order (90-day supply)
Tier 1 (lowest-cost options) 100% after $37.50 copay 100% after deductible
Tier 2 (medium-cost options) 100% after $87.50 copay 100% after deductible
Tier 3 (highest-cost options) 100% after $187.50 copay 100% after deductible

15
Dental Plan Options
Little Bird offers the following three dental plan options Other ways the dental options are similar include:
to choose from, all administered by Empire BlueCross  You have access to the same nationwide network of dentists
BlueShield: and dental specialists. To find a network provider in your
 Comfort Dental Plan area, go to www.empireblue.com and select Find a Doctor.
Next, select your state followed by plan/network. Be sure
 Stability Dental Plan
to choose Dental Complete as your network.
 Tranquility Dental Plan
 You can choose to use any provider; if you choose to use
You do not have to enroll in medical to enroll in dental the network, you will generally pay less.
coverage, and if you do enroll in medical, your plan names  Preventive care is covered at 100% with no deductible.
do not have to match. For example, you can enroll in one
 If you enroll in the Tranquility or Stability dental plan
of the Comfort medical plan options but choose the
option, you also receive coverage for adult and child
Tranquility Dental Plan.
orthodontic services.
Each plan provides coverage for exams, x-rays, cleanings,
fillings, and major dental work such as crowns and bridges.
Brush biopsy (cancer screening), additional cleanings during
pregnancy or if diabetic, and composite fillings on all teeth
are some additional services covered under all plans.

Compare Your
Dental Plan Options
Each Little Bird dental plan option
provides a different level of coverage
for a different price tag. Generally,
the more comprehensive options
have a higher price tag. Review
page 17 and refer to your 2015
Benefits Shopping List to see how
the coverage and price tags compare. 16
How Your Dental Options Compare
The following chart shows the coverage provided under each Little Bird dental plan option.

Comfort Dental Plan Stability Dental Plan Tranquility Dental Plan


Network Non-Network Network Non-Network Network Non-Network
Maximum the Plan
$750 per person $1,000 per person $1,500 per person
Pays per Calendar Year
Annual Deductible
$100/$300 $100/$300 $100/$300 $100/$300 $100/$300 $100/$300
(individual/family)
Preventive/Diagnostic Plan pays 100%, Plan pays 100%, Plan pays 100%, Plan pays 100%, Plan pays 100%, Plan pays 100%,
(oral exams, cleanings,
fluoride, sealants, x-rays)
no deductible no deductible no deductible no deductible no deductible no deductible

Basic Restorative Plan pays 80% Plan pays 50% Plan pays 90% Plan pays 60% Plan pays 100% Plan pays 80%
(fillings, extractions,
oral surgery, root canals)
after deductible after deductible after deductible after deductible after deductible after deductible

Major Restorative Plan pays 25% Plan pays 10% Plan pays 50% Plan pays 25% Plan pays 60% Plan pays 50%
(crowns, bridges, dentures) after deductible after deductible after deductible after deductible after deductible after deductible
Orthodontic Plan pays 50% Plan pays 50% Plan pays 50% Plan pays 50%
Not covered Not covered
(adults and children) after deductible after deductible after deductible after deductible
Separate Orthodontic
Not applicable Not applicable $2,000 per person $2,000 per person
Lifetime Maximum

17
Vision Plan Options
Little Bird offers the following three vision plan options to Some ways these options are similar include:
choose from, all administered by Vision Service Plan (VSP):  You have access to the same nationwide network of vision
 Comfort Vision Plan care specialists. To find a network provider in your area,
go to www.vsp.com.
 Stability Vision Plan
 You can choose to use any provider; if you choose to use
 Tranquility Vision Plan
the network, you will generally pay less.
You do not have to enroll in medical or dental to enroll in vision  You do not need a vision plan ID card. When you go for
coverage, and if you do enroll in medical or dental, your plan care, just be sure to give your Social Security number
names do not have to match. For example, you can enroll to the provider for you or your covered dependents.
in one of the Comfort medical plan options but choose the
 Each plan covers similar types of services.
Stability Vision Plan.

Compare Your Vision


Plan Options
Each Little Bird vision plan option
provides a different level of coverage
for a different price tag. Generally,
the more comprehensive options
have a higher price tag. Review
page 19 and refer to your 2015
Benefits Shopping List to see how
the coverage and price tags compare.
18
How Your Vision Options Compare
The following chart shows the coverage provided under each Little Bird vision plan option.

Comfort Vision Plan Stability Vision Plan Tranquility Vision Plan


Network Non-Network Network Non-Network Network Non-Network
Routine Vision Exam Plan pays 100% Reimbursed Plan pays 100% Reimbursed Plan pays 100% Reimbursed
(once every 12 months) after $20 copay up to $50 after $10 copay up to $50 after $10 copay up to $50
Frames
(once every 12 months except Plan pays $100 Reimbursed Plan pays $150 Reimbursed Plan pays $180 Reimbursed
for Comfort Vision Plan, which after $20 copay1 up to $70 after $25 copay1 up to $70 after $25 copay1 up to $70
is once every 24 months)
Single Vision Lenses Plan pays 100% Reimbursed Plan pays 100% Reimbursed Plan pays 100% Reimbursed
(once every 12 months)2 after $20 copay up to $50 after $25 copay up to $50 after $25 copay up to $50
Bifocal Lenses Plan pays 100% Reimbursed Plan pays 100% Reimbursed Plan pays 100% Reimbursed
(once every 12 months)2 after $20 copay up to $75 after $25 copay up to $75 after $25 copay up to $75
Trifocal Lenses Plan pays 100% Reimbursed Plan pays 100% Reimbursed Plan pays 100% Reimbursed
(once every 12 months)2 after $20 copay up to $100 after $25 copay up to $100 after $25 copay up to $100
Contact Lenses Plan pays Plan pays Plan pays
Reimbursed Reimbursed Reimbursed
(once every 12 months up to $100 up to $150 up to $180
up to $85 up to $105 up to $105
in lieu of glasses) for contacts for contacts for contacts
1
You are eligible for a 20% discount after you reach the plans maximum allowance.
2
Standard plastic lenses.

Take note:
 If you enroll in the Stability Vision Plan, photochromic lenses are covered in full.
 If you enroll in the Tranquility Vision Plan, progressive lenses, photochromic lenses, anti-reflective coating, and scratch
coating are covered in full.

19
Tax-Advantaged Savings Accounts
Little Bird offers the following options to save money on your taxes for eligible expenses you are already paying for:
 Health Savings Account (HSA)
 Health Care Flexible Spending Account (FSA)
 Health Reimbursement Account (HRA)
 Dependent Care FSA
 Commuter Reimbursement

The HSA is administered by Empire. More details will be provided to you from Empire directly.
All other plans are offered through AMERIFLEX. When it comes time to get reimbursement from your AMERIFLEX
account, it is simple. When you enroll, you will receive the AMERIFLEX Convenience Card. This debit card works similarly
to your regular bank debit card because it provides electronic access to the funds in your tax-advantaged savings accounts.
You can use the same card for all the plans you are enrolled in. Simply present your card to your provider or for eligible
commuter expenses. When your card is swiped, the system qualifies the expense to ensure that the expense and provider
or merchant are eligible under your plan, and then your claim is paid, up to the balance in your account.
You can also set up the AMERIFLEX member online account manager at www.flex125.com. Go to the Member drop-down
and select the Member Portal Login link. You can register under the login box on the left side of your screen by clicking on
New User. From here, follow the instructions to set up your user name and password.
Your user name and password are what you will use to access your online account manager going forward, where you can:
 Update your personal information
 Request a new AMERIFLEX Convenience Card
 Access and update direct deposit information
 View details about eligible expenses
 Email the member services team
Questions?  Opt in and out of email communications

Have any questions about


 Submit claims online or download a claim form
tax-advantaged accounts and/or  Have reimbursement sent directly to a provider
IRS rules? Go to www.ex125.com  And more
or call 1-888-868-FLEX (3539). 20
HSA
If you enroll in the Comfort HSA Plan, the Stability HSA Important IRS Rules
Plan, or the Tranquility HSA Plan, you are eligible to enroll
 If you are married and your spouse is enrolled in a
in an HSA, which is an easy-to-use special bank account
separate high deductible health plan, your combined
owned entirely by you. That means it is yours to keepeven
HSA contributions cannot exceed the federal maximum
if you no longer work at your school or change medical plans.
for HSA contributions, listed above.
Plus there are multiple tax advantages, which means more  To be eligible for the HSA, you must not be enrolled
savings for you.
in Medicare or Medicaid, or be claimed on another
 It is tax-free when it goes in. In 2015, you can contribute persons tax return.
up to $3,350 for employee-only coverage or up to $6,650  Always keep your receipts when you withdraw money
for all other coverage levels. If you are age 55 or older, you from your HSA. You do not need to submit them for
may make an additional $1,000 catch-up contribution. reimbursement, but they are good to have if you ever
 It is tax-free as it grows. The money you contribute do need to provide proof of your eligible expenses to
grows with interest, and you dont pay taxes on the the Internal Revenue Service (IRS).
interest you earn.  If you or your spouse is contributing to an HSA and wants
 It is tax-free when you spend it. When you have an eligible to contribute to a Health Care Flexible Spending Account
health care expense, you may access the balance in your (FSA), it becomes a Limited Purpose FSA, which can only
account as described on page 20. be used for eligible vision and dental expenses.
You can start, stop, or change the amount of your HSA  Only use your HSA for qualified health care expenses.
contributions at any time during the year through the Little Otherwise, you will pay income taxes on that distribution
What Are Eligible Bird benefits store at www.littlebird.bswift.com. and an additional 20% penalty tax if you are under age 65.
Health Care Expenses
under the HSA?
Eligible expenses include things
like medical, dental, and vision
deductibles, copays, and coinsurance;
out-of-pocket prescription drug
costs; medical equipment like
wheelchairs; and vision and hearing
expenses. For a complete list, go
to www.irs.gov/publications/p502.
21
Health Care FSA
You can enroll in the Health Care FSA, regardless of the medical plan you choose. However, if you enroll in a medical plan
with an HSA, your Health Care FSA becomes a Limited Purpose FSA, which means you can only use it for eligible vision
and dental expenses.

How the Health Care FSA Works Important IRS Rules


 You may contribute up to $2,550 pre-tax each year.  You must use the balance in your account by December 31
 Your contributions are equally deducted from your of every year.
paycheck before taxes, which means you are savings  Any balance over $500 in your Health Care FSA as
anywhere from 15% to 30%, depending on how much of December 31 of every year is forfeited. This is called
you earn. the IRS use-it-or-lose-it rule.
 You can use the balance in your account to pay for eligible  If you have $500 or less in your Health Care FSA as
health care expenses for yourself and anyone you claim of December 31 of every year, the IRS use-it-or-lose-it
as a dependent on your income taxes. See page 20 for rule does not apply. Your balance of $500 or less
submitting claims. automatically rolls over in April of the following year,
 Eligible expenses include things like medical, dental, and so you can use it toward eligible health care expenses.
vision deductibles, copays, and coinsurance; out-of-pocket  If you want to contribute (outside of the $500 rollover
prescription drug costs; medical equipment like wheelchairs; balance noted in the bullet above), you must make an
and vision and hearing expenses. election every year. Re-enrollment is not automatic.
 Expenses that are not eligible include health care premiums  If you enroll in Little Birds Health Savings Account (HSA)
(or payroll contributions), any health care expenses that you and want to participate in the Health Care FSA, you can
receive reimbursement for from any plan, and any expenses only use your Health Care FSA for eligible vision and dental
that you claim on your federal tax return. expenses, so you will want to budget carefully.

What Are Eligible


Health Care Expenses
under the Health
Care FSA?
Get a complete list of
eligible expenses at
www.irs.gov/publications/p502.
22
HRA
If you waive coverage or enroll in a medical option that costs less than your Benefit Bucks, your balance automatically
is deposited into an HRA. You can use the HRA to pay for eligible health care expenses, up to the balance in your account.
It is important to note that if you have money in an HRA, you must use all of your HRA funds in 2015. Any balance will
not roll over into 2016. See page 20 for submitting claims.

What Are Eligible


Health Care Expenses
under the HRA?
Get a complete list of
eligible expenses at
www.irs.gov/publications/p502.

23
How the Accounts Compare
Here is an overview of how these tax-advantaged savings accounts compare and work:

Limited Purpose
HSA Health Care FSA HRA
Health Care FSA
Waive Coverage
Medical Plan Option HSA only HSA only EPO or PPO or Unused
Benefit Bucks
Eligible Expenses Typically broader than Dental and vision only Any IRS eligible health Any IRS eligible health
under an FSA (e.g., care expense that is not care expense that is not
long-term care premiums, reimbursed by insurance reimbursed by insurance
acupuncture, medical,
dental, and vision expenses)

Amounts Eligible Unused funds roll over from You may carry over You may carry over You must use your
for Carry-Over year to year. up to $500 each up to $500 each balance during the
plan year; you lose plan year; you lose plan year or lose it.
any amounts higher any amounts higher
than $500. than $500.

Portability You own your account. You do not own this You do not own this You do not own this
You can take your balance account; however, account; however, account. You lose
with you when you leave you may continue you may continue your balance once you
your school or change to contribute on to contribute on leave your school.
HSA and Limited medical plans to use on
future eligible expenses.
an after-tax basis
for a limited time
an after-tax basis
for a limited time
Purpose Health Care through COBRA. through COBRA.
FSA Are Designed After Retirement Your HSA balance can Not applicable Not applicable Not applicable
to Work Together. be used to pay Medicare
premiums, deductibles,
Your HSA will be used to pay for coinsurance, and co-pays
all medical-related expenses; tax-free in retirement.
therefore, you are eligible to enroll
Investment Options You have a choice of invest- Not applicable Not applicable Not applicable
in a Limited Purpose Health Care ment options in which to
FSA to pay for eligible dental and invest your HSA balance.
vision expenses, allowing you to
preserve your HSA funds for
savings and investment
opportunities. 24
Dependent Care FSA
You can choose to enroll in this plan and may contribute up Important IRS Rules
to $5,000 pre-tax each year. Then you can use the balance
 If you are married and your spouse contributes to
in your account to pay for eligible expenses like day care,
a Dependent Care FSA, your combined contribution limit
before- and after-school programs, and elder care that
is $5,000 a year. If you are married and file separate tax
are necessary for you and your spouse to work (or for
returns, your maximum contribution is $2,500 a year.
your spouse to attend school full-time).
 You must use the balance in your account by December 31
The care may be provided in your home, someone elses
of every year. Any unused balance is forfeited. This is called
home, or a licensed day care center. Examples of eligible
the IRS use-it-or-lose-it rule.
dependents include:
 If you want to contribute, you must make an election
 Your children under age 13, who you claim on your every year. Re-enrollment is not automatic.
federal income tax return.
 If you enroll in the Dependent Care FSA, you may
 A spouse who is mentally or physically incapable not claim credits on your income tax return for the
of caring for himself or herself. same expenses.
 Elderly parents or older children who are disabled,  You may not transfer money back and forth between
What Is Not an Eligible spend at least eight hours a day in your home, and the Health Care FSA and Dependent Care FSA.
are claimed as dependents on your tax return.
Expense under the
If you enroll in the Dependent Care FSA, you pay your
Dependent Care FSA? provider directly and then submit claims, up to the balance in
Tuition or school expenses for your account, through MyPlanConnect at www.flex125.com.
kindergarten and above, overnight
camps, expenses for non-disabled
children age 13 and above, and
day care expenses while you are
not working.
Dependent day care expenses
if your spouse or other dependent
(e.g., an older sibling) is providing
the care.
Get a complete list of eligible expenses
at www.irs.gov/publications/p503. 25
Commuter Reimbursement
You generally pay for your commuter expenses with Important IRS Rules
money that has been taxed through your paycheck. With
 IRS regulations do not permit reimbursements for
the Commuter Reimbursement account, you can pay for
expenses older than 180 days from the date the expense
eligible expenses pre-tax. This means money is deducted
was incurred, so you will want to submit your claims
through convenient paycheck deductions before taxes are
as soon as possible.
taken out. Since you do not pay tax on this money, you are
saving automatically on money you are already spending.  Any excess balance carries over to the following month.
You can contribute up to: However, you can only spend the amount of the monthly
IRS limit ($250 for parking and $130 for transit) in any
 $130 a month for transit (bus or train) for things such
given month. See page 20 for submitting claims.
as passes, tokens, fare card, voucher, or similar items.
 $250 a month for qualified parking expenses for things like
parking at a location for commuter vehicle or vanpool, mass
What Is Not an transit facilities, a garage near work, and parking meters.
Eligible Expense
under the Commuter
Reimbursement
Account?
Highway tolls (EZ Pass), tolls for
tunnels and bridges
Fuel, mileage, or other costs incurred
to operate a personal vehicle or taxi
Non-work-related transportation
or parking expenses
Expenses incurred in traveling
from your office to business or
client meetings
Spouse/dependent transit or
parking expenses
Any claim submitted 180 days or
more after the expense was incurred 26
Income Protection
As an eligible employee, you receive certain benefits automatically, at no cost to you, which help to protect your income
if something should happen to you.
 Basic Life and Accidental Death & Dismemberment (AD&D) Insurance
 Short-Term and Long-Term Disability

In addition, there are optional plans that are available to you if you want to purchase additional protection, depending
on your needs:
 Supplemental Life Insurance
 Accident Insurance
 Critical Illness Insurance
 AFLAC (available at certain locations only)

Each of these plans is described in more detail on the pages that follow. If you have questions about your income protection
benefits, contact the applicable insurance carrier listed on page 43.

27
Basic Life and AD&D Insurance
Basic life insurance pays a lump sum benefit to the person or Additional Services at No Cost to You
people you have chosen, called your beneficiaries, if you
The following services are included at no extra charge
die while covered under this plan.
with your Basic Life and AD&D coverage: Will and Trust
As an eligible employee, you automatically receive basic life Preparation, Beneficiary Services, Resource Advisor,
insurance equal to one times your annual earnings (round Telephonic Employee Assistance Program (three face-
up to the next higher multiple of $1,000), up to a maximum to-face counseling sessions), Unlimited Legal and Financial
of $500,000. (Note: Benefit amounts are reduced to 35% Consultations, Identity Theft Victim Recovery Services,
at age 65 and 50% at age 70.) Beneficiary Support Programs, and Travel Assistance.
You also automatically receive AD&D benefits, which pays You will receive additional information about how to
your beneficiaries an additional lump sum amount equal to access these services from the insurance carrier,
your basic life insurance benefit if your death is the result Anthem BlueCross BlueShield.
of a covered accident. In some cases, the AD&D Plan will
pay you a level of benefits if you are seriously injured in
a covered accident or if you lose a limb, your sight, or your
hearing. In this case, benefits are based on the type of loss.

Accelerated
Death Benefit
If you are diagnosed as terminally ill,
with a life expectancy of 12 months
or less, you may be eligible to receive
payment for a portion of your life
insurance. The remaining amount
is payable to your beneficiaries upon
your death.

28
Disability Insurance
Little Bird provides disability insurance to all eligible full-time employees, at no cost to you. There are two
levels of coverage that replace a portion of your income if you become sick or are injured and unable to work.

Short-Term Disability (STD)


If you are sick or injured for more than seven consecutive days, the STD Plan replaces 60% of your weekly salary,
up to a maximum of $1,500 per week, for up to 26 weeks. Benefits begin on the eighth day after a covered accident
or illness.

Long-Term Disability (LTD)


If your injury or illness lasts for more than 180 consecutive days, you may be eligible for LTD benefits. The LTD Plan
replaces 60% of your weekly salary, up to a monthly maximum of $7,500. Benefits begin 180 days after a qualifying
accident or illness and end at recovery or at the Social Security normal retirement age.

29
Supplemental Life Insurance
Everyone has different life insurance needs. That is why, as a part of your Little Bird benefits shopping experience, you have
the opportunity to buy more coverage if you want it. If you buy additional coverage for yourself, you may also buy coverage
for your spouse and child(ren).
The following chart outlines amounts available to you. Keep in mind that you can enroll in supplemental life insurance at any time
during the year. If you enroll, you receive discounted group rates, as outlined on your 2015 Benefits Shopping List, which are
conveniently deducted from your paychecks on an after-tax basis.

Coverage for Yourself Coverage for Your Spouse Coverage for Your Child(ren)
Up to five times your annual earnings, Flat dollar amount in increments of Flat dollar amount in increments of
in increments of $10,000, up to $5,000, not to exceed 50% of your $2,000, up to a maximum of $10,000
a maximum of $500,000 supplemental life insurance amount for each child (age 14 days to 26 years)

There are some cases in which you and your spouse must provide Evidence of Insurability (EOI), also known as proof of good
health. If any of the following situations apply to you, you will receive a form during enrollment to complete and submit to the
address on the form:
 Employee coverage amounts of more than $200,000 when you are initially eligible.
 Spouse coverage amounts more than $25,000 when you are initially eligible.
 Any coverage amounts for you and your spouse after you are initially eligible (for example, during Annual Enrollment).

30
Accident Protection Plan
Some of us like knowing that we are covered if something should happen to ustaking the risk out of doing the things we love
to do. That is what the Accident Protection Plan, available through UnitedHealthcare, is all about. It pays a cash benefit directly
to you for covered accidental injuries to help cover the cost of emergency medical care, rehab, and other related expenses.
You can choose to purchase from the following two levels of coverage for a flat monthly fee, as outlined on your 2015 Benefits
Shopping List.1 The cost is conveniently deducted from your paychecks on an after-tax basis:
 Base Only: Pays a benefit for accidental death and dismemberment, initial care, and hospitalization.2
 Base + Enhanced: Pays a benefit for the same things as base, plus provides additional benefits for follow-up care and
covered services.2
1
The cost of coverage may be waived for up to six months if you have been totally disabled as a result of a covered accident and remain so for more than 30 consecutive days.
2
If you have been covered under the plan for at least six months, you can take this coverage with you if you leave your school for any reason and continue to pay the cost of coverage
directly to UnitedHealthcare.

31
AFLAC
AFLAC offers you an extra measure of financial protection. If you become sick or are injured, this plan pays a cash benefit
to help you and your family with unexpected expenses. The benefits are pre-determined and paid regardless of any other
insurance you have.
If you enroll and are eligible for benefits, you can use the money any way you choosewhether to cover lost income so that
you can pay for your daily living expenses, or to pay toward medical plan deductibles, copays, and other out-of-pocket medical
expenses. You have three options to choose from:
 Hospital Indemnity Insurance: This option pays a flat dollar amount if you are hospitalized for invasive diagnostic exams,
surgery, or childbirth.
 Specified Disease Insurance (Cancer): This option pays a flat dollar amount if you are diagnosed with cancer to help you
manage your expenses while you are getting well.
 Accident Indemnity Advantage: This option pays a flat dollar amount if you experience an unexpected impact that leads
to broken bones, burns, concussion, laceration, or other related injuries.

Take Note!
Eligibility for this plan varies, so it
may not be available at all schools.
If you are eligible to enroll, you can
do so at any time during the year.
Go to www.littlebird.bswift.com
and access the Springboard tab
at the top of your screen.
32
Critical Illness Insurance
If you are a regular, full-time employee, you may choose to purchase Critical Illness Insurance through UnitedHealthcare.
You must elect coverage for yourself in order to elect coverage for your spouse and/or child(ren). This plan provides another
form of financial protection if you or an eligible family member becomes critically ill; examples include cancer, heart attack,
stroke, coma, permanent paralysis, severe burns, or major organ failure.
Specifically, you receive a lump sum cash benefit that you can use any way you choosewhether to cover lost income
so you can pay for your daily living expenses, or to pay toward medical plan deductibles, copays, and other out-of-pocket
medical expenses.
If you elect coverage for yourself, you may also purchase coverage for your spouse and child(ren). The following chart
outlines amounts available to you. Keep in mind that you receive discounted group rates, as outlined on your 2015 Benefits
Shopping List, which are conveniently deducted from your paychecks on an after-tax basis.

Coverage for Yourself 1 Coverage for Your Spouse Coverage for Your Child(ren)
A at dollar amount between $5,000 A at dollar amount of $5,000 A at dollar amount of $3,000
and $10,000, in increments of $1,000 for each child, up to age 26

No Evidence of Insurability (EOI, also known as proof of good health) is required when you are first eligible to enroll; however,
if you enroll after your initial eligibility (for example, during Annual Enrollment), EOI is required.
If you enroll, you and your spouse may each be eligible for an annual wellness benefit of $100 for completing a covered
wellness screening, such as colonoscopy, chest x-ray, mammogram, or Pap smear.

1
If you have been covered under the plan for at least six months, you can take this coverage with you if you leave your school for any reason and continue to pay the cost of coverage
directly to UnitedHealthcare.

Covered
Illnesses Include:
Category 1: Cancer, Carcinoma in
Situ (partial benefit only)
Category 2: Heart Attack, Heart
Transplant, Coronary Artery Bypass,
Ruptured Aneurism, Stroke
Category 3: Chronic Renal Failure 33
Value-Added Benefits
In addition to the unique shopping experience for your health and income protection plans, Little Bird offers several value-
added benefit options that help you save money, live well, and feel good. You can purchase these benefits online anytime
during the year at www.littlebird.bswift.com. Go to the Springboard tab at the top of your screen.

Pet Insurance
Medical expenses for our four-legged loved ones can get costly, especially for those with certain veterinary conditions or who
need surgery. You can choose to purchase pet insurance to cover eligible expenses, which can protect you from the high costs
of veterinary care. You can choose from the following three options available through VPI, a leader in pet insurance.

Major Medical Plan Major Medical Plan Pet Wellness Basics


(Comprehensive + Wellness) (Comprehensive) (Everyday care)
Use Any Vet Yes Yes Yes

$250 for medical claims


Annual Deductible $250 $0
$0 for wellness claims

Wellness Services, Including


Exams, Vaccinations, X-rays, Yes No Yes
Flea and Heartworm Preventive

Accidents, Illnesses, Hereditary


Yes Yes No
Conditions, Surgeries, Hospitalization

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Value-Added Benefits (continued)
CareXtend
You can choose to purchase coverage under CareXtend, which is the first online marketplace designed to help reduce
your spending on health and wellness. Examples include body treatments (such as body contouring, hair removal sessions,
and facials), weight loss programs, Botox, and much more! This way you save on services you already use to stay healthy,
and the money you are already spending goes even further.

ID Watchdog
You can choose to purchase coverage under this plan, which provides you with a strong frontline defense against identity theft.
ID Watchdog offers several solutions that all provide identity monitoring, identity theft detection, and fully managed resolution
services. If you sign up, they monitor thousands of public and private databases for new and updated information associated
with your personal, identifiable, and financial information. This also includes monitoring Social Security numbers, criminal records,
address history, and more. They provide you with a 100% guaranteed identity solution. You can choose to enroll yourself only
or your entire family in one of the following options:

ID Watchdog 1B Features: ID Watchdog Platinum Features:


Single-bureau credit monitoring Tri-bureau credit monitoring
Annual TransUnion credit report and score Annual tri-bureau credit report and score
Identity monitoring Identity monitoring
Alternative lending monitoring Alternative lending monitoring
High-risk transaction monitoring High-risk transaction monitoring
Cyber monitoring Cyber monitoring
$1 million reimbursement insurance $1 million reimbursement insurance
Non-credit loan monitoring Non-credit loan monitoring
Address monitoring Address monitoring
Lost wallet vault monitoring Lost wallet vault monitoring
100% resolution guarantee 100% resolution guarantee
Solicitation reduction assistance Solicitation reduction assistance

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Value-Added Benefits (continued)
Legal Service Plan Examples of covered services include:
 Debt Collection Defense
You can choose to purchase group legal coverage available
through MetLaw. Your cost of coverage is conveniently  Identity Theft

deducted from your paychecks on an after-tax basis.  Adoption


 Immigration Assistance
This plan offers a network of more than 13,000 participating
attorneys. When you stay in-network, there are no waiting  Tenant Negotiations
periods or claim forms, and most covered legal services  Sale of a Home
are provided at no additional cost to you.  Purchase of a Home
You can also choose to use an attorney outside of the  Mortgages
network. In this case, you are responsible for paying the  Traffic Ticket Defense (No DUI)
difference between the reimbursement amount and  Living Wills
attorneys charges, if any.
 Powers of Attorney
 Wills
 Name Change
 Administrative Hearings
 Civil Litigation Defense
 Incompetency Defense
 Deeds
 Demand Letters
 Telephone and Office Consultations
 And more

Plus, you have access to a host of trusted online tools


and educational resources that allow you to create
legally valid, state-specific documents.

36
Perks and Discounts
Little Bird partners with Abenity to offer you a number Benefits for Your Well-Being
of perks and discounts for your wallet and your well-being,
Through this program, you can get access to healthy
at no cost to you. You will receive a welcome email from
recipes, grocery store coupons, healthy living tips, a pharmacy
our partners at Abenity with instructions on how to log in.
discount card, video libraries, wellness radio, and more!

Benefits for Your Wallet Benefits for Your Personal Life


You have access to over $4,500 in discount offers, which are Do you need help handling the little details in life, such as car
redeemable in-store through printable and mobile coupons, rental, home maintenance, child care services, wake-up calls,
online, and over the phone. Specifically, you can save when air travel, taxi services, etc.? You can upgrade your perks for
you make purchases through Costco, Sams Club, BJs, Sprint, just $84.15 to have access to a concierge service. Concierge
Firestone, Papa Johns, DirecTV, T-Mobile, Dell, Target.com, professionals are available 24 hours a day, seven days a week,
Verizon Wireless, Overstock.com, Brooks Brothers, K&G, 365 days a year, to help you organize your life. All you need
Mens Warehouse, Ballys Total Fitness, Southwest Airlines, to do is log on to http://littlebird.abenity.com and register for
Enterprise Rent-A-Car, and Hewlett-Packard. Concierge Services by clicking on the Perks and Discounts
In addition, you have access to savings at over 150 national drop-down in the top right corner of your Abenity account,
attractions and theme parks, including the Walt Disney and then clicking on Concierge.
Celebrate Savings! World Resort, Universal Studios, SeaWorld, Cirque du Soleil,
and Six Flags!
Access your discount coupons.
Locate popular discounts and
personalize/save them as your
favorite offers.
Browse offers by zip code, city,
category, and vendor name.
Stay connected through
blog posts.
Get monthly spotlights
on new offers and discounts.
View short how to videos.
Get a copy of the Annual Savings
Guide for discounts on the go. 37
Employee Assistance Program
Little Bird offers you Resource Advisor through AnthemLife, Resource Advisor Can Help if Your
at no cost to you. This is a confidential resource that you can
access when you feel pressure from everyday problems; for
Identity Is Stolen
example, those related to family issues or work. You and your If your wallet or purse is lost or your identity is stolen,
family can call 1-888-209-7840, 24 hours a day, seven days call Resource Advisor, and AnthemLife will assign you
a week, to talk to a Resource Advisor counselor who can: a Fraud Resolution Specialist to help get your identity
back and restore your good credit. Services include:
 Give you advice and arrange for up to three face-to-face
visits with a counselor if you need them.  Placing fraud alerts on credit reports and with creditors.
 Put you in touch with a financial advisor if you have money  Closing bank and credit card accounts where your identity
problems. is an issue.
 Connect you with a lawyer if you need legal help. You can  Arranging a phone meeting with a financial counselor.
meet by phone or in person.  Setting up a meeting with a lawyer on issues around
identity theft.
You can also visit www.ResourceAdvisor.Anthem.com
(log in with the program name: AnthemResourceAdvisor) Please note: The identity theft benefit that automatically
where you will find: is available under the Employee Assistance Program differs
from ID Watchdog, described on page 35. ID Watchdog
 Tips on handling difficult life events and a depression
is a more comprehensive plan that includes monitoring
screening tool.
and fully managed resolution services.
 Parenting information, including a child and elder care
provider finder.
 Financial tools to help you plan for major purchases
or life events.
 A place to register for identity theft monitoring
at no cost to you.
 State-specific online wills and a legal library.

38
ShapeUp Complete

Looking for ways to stay on top of your fitness routine? Join Little Birds ShapeUp Complete program. With the support of
your colleagues, ShapeUp allows you to set healthy goals, track your progress, and participate in school-wide fitness challenges.
 Set Healthy Goals: Go to the ShapeUp website at  Build a Supportive Network: Stay engaged by inviting
https://members.shapeup.com. Go to Join Now and colleagues to join your ShapeUp team. Create teams
enter the company name as Little Bird. Then register and invite colleagues, or make your team public so that
using your work email address and create your log-in anyone can join.
credentials. You will be prompted to order your welcome  Join in Fun Challenges: Getting fit is even more fun when
kit to use online self-assessments, which can help you you do it with others. Each quarter, a new eight-week
determine what you want to achieve. challenge will be introduced at your school that is centered
 Track Your Progress: You can also track your progress on healthy activities, such as fitness, nutrition, or a balanced
on the ShapeUp website. There are several online tools lifestyle. So be sure to keep an eye out for details.
to see how your fitness level is improving over time. You
can even set up progress reports via text messages or
access a smartphone app, such as RunKeeper, that
integrates directly with ShapeUp.

Steps to Stay Healthy


To help you keep track of your
goals, you will receive a free digital
pedometer in your welcome kit.
Pedometers show you just how
many steps you take each day.
39
Programs to Help You Live Well
If you enroll in one of the Little Bird medical plan options, LiveHealth Online
you and your eligible dependents have access to the
You have an opportunity to sign-up for LiveHealth
Empire BlueCross BlueShield 360 Health Programs,
Online, which is a simple way to access health care
at no additional cost to you. From online resources to
24 hours a day, seven days a week, in a confidential,
personal attention from registered nurses, 360 Health can
secure, and convenient way.
help you become more engaged in your health, make better
health care decisions, and get the most out of life. Once you sign up, you can easily access the service at
www.livehealth.com from any computer, tablet, or mobile
See the following pages to learn more about what is available.
device with video capability. Here you can consult with
To access these programs, unless otherwise noted, you can
a U.S. board-certified doctor, who can diagnose your
call the phone number on the back of your medical ID card
symptoms and even prescribe basic medications when
or log on to your Empire account at empireblue.com.
needed. You pay the same as you do for any other doctor
office visit under your medical plan.
Future Moms
The advantage of LiveHealth Online is that you:
You will be able to get screenings and support during your
entire pregnancy, including access to maternity nurse  Get quick answers to your health questions.
coaches, 24 hours a day, seven days a week.  Avoid having to leave home if you are not feeling well.

Note: LiveHealth Online currently is not available in AL, AK,


Gym Reimbursement AR, LA, NH, and TX. Consultation only (no prescriptions)
As a medical plan participant, you and your eligible in CO, ID, IN, MO, and TN.
dependents can save money on your fitness memberships
Stay Connected through the gym reimbursement program. Specifically,
if you or your legal spouse or domestic partner visits the same
Become a member of the gym at least 50 times during a six-month reimbursement
Empire BlueCross BlueShield period, you can receive reimbursement for a portion
Facebook group: Health. Join in.
of your yearly membership dues. You will receive more
Follow on Twitter @HealthJoinin information and claim forms for reimbursement as a part
Find health tips and sign up of your Empire BlueCross BlueShield enrollment kit.
for a weekly health-related
text message at empireblue.com

40
Programs to Help You Live Well
(continued)
24/7 NurseLine ComplexCare
Sometimes you have a quick medical question that you just Consult with registered nurses, set healthy lifestyle goals,
want to ask someone. As a medical plan participant, you will and get help coordinating your care.
be able to consult with a registered nurse and receive instant
health care information. MyHealth Advantage
Receive timely alerts about potential gaps in care,
Online Health Assessment avoid critical health issues, and save money on certain
Log on to your Empire account at empireblue.com to access health-related expenses.
the confidential Online Health Assessment. You will be asked
to answer questions about lifestyle and behaviors. In return, Wellness Incentive Program
you will better understand your current health status, identify
If you are enrolled in a Little Bird medical plan, you can
positive changes you can make, and track your success.
participate in the SimplyEngaged wellness program.
This is a school-wide initiative that encourages you and your
ConditionCare spouse to create and maintain a personal wellness program.
If you or an eligible dependent enrolled in your medical plan
Specifically, you will have opportunities to complete
has certain ongoing or chronic conditions, you can receive
wellness activities, including a health assessment, an online
guidance on following your care plan, consult with nurse
health coaching program, and a telephone-based coaching
coaches, and better manage your health.
program. Each time you complete an activity, you will be
rewarded with a gift card to a national retailer.

41
How to Enroll
Once you are done shopping for your Little Bird benefits, it Throughout the process, you will see a running total of how
is time to check out. You can easily purchase your benefits at much you are spending in the upper left-hand navigation
the Little Bird benefits store at www.littlebird.bswift.com. bar. You can review or change your election by clicking on the
If you do not have access to the Internet, you can call the specific benefit. At the end of the process, review your final
Little Bird Support Center at 1-877-206-5694. page to make sure that everything looks accurate. If it does
not, click the applicable button to update. If it looks accurate,
If you enroll online, go to the Enroll Now button after you
click I agree to the changes I have made and I am finished
log on. You will automatically be guided through the online
with my enrollment, and then click Save My Enrollment.
benefits shopping experience, including a tool to help you
decide on the medical plan option that is best for you and Make sure you print your confirmation page and keep it
your family. As you enroll in each benefit, be sure to click for your records. You will see that you also have the option
the dependents you want to cover. Then click the Save of emailing it to yourself.
and Continue button.
The Little Bird benefits store only supports the following browsers:
Important! You may not use the Back button through
Microsoft Internet Explorer (any version other than 7.0 or older),
your Internet browser or you will be logged out automatically Mozilla Firefox version 2.0.0.4 and up, Google Chrome version
and your elections may not be saved. You should always use 19.0.1084.52 and up, and Safari version 4.0.1 and up. You may
the navigation bar on the left side of your screen. want to try to access the site as soon as possible to make sure
you have enough time to update your browser if needed.

Benefits You Can


Enroll in Anytime
During the Year
There are some benefits you can
enroll in anytime during the year,
such as Supplemental Life Insurance,
AFLAC, and the Valued-Added
Benefits described on pages
34-36. When you log on to
www.littlebird.bswift.com, go to
the Springboard tab at the top
of your screen.
42
Have Questions or Want More Information?
For: Contact: By Phone: Online:
General Questions about Eligibility
Little Bird Support Center 1-877-206-5694 www.littlebird.bswift.com
and How to Enroll
Medical Empire BlueCross BlueShield 1-800-662-5193 www.empireblue.com
Prescription Drugs Empire BlueCross BlueShield 1-800-662-5193 www.empireblue.com
Dental Empire BlueCross BlueShield 1-877-567-1799 www.empireblue.com
Vision Vision Service Plan 1-800-877-7195 www.vsp.com
HSA Empire 1-866-686-4798 www.mybenefitwallet.com
FSAs, HRA, and Commuter Reimbursement AMERIFLEX 1-888-868-FLEX (3539) www.flex125.com
Basic Life and AD&D Insurance Anthem BlueCross BlueShield 1-866-227-5348 www.empireblue.com
Disability Insurance Cigna 1-800-36-Cigna www.cigna.com
Accident Protection Plan UnitedHealthcare 1-800-539-0038 Not applicable
AFLAC AFLAC 1-800-992-3522 http://aflac.com/littlebird
Critical Illness Insurance UnitedHealthcare 1-888-299-2070 Not applicable
Pet Insurance VPI 1-877-PETS-VPI http://www.petinsurance.com/springboard
https://www.carextend.com/promo/index.
CareXtend CareXtend 1-800-251-4920 aspx?landing=springboard
ID Watchdog ID Watchdog 1-866-513-1518 www.idwatchdog.com
Legal Service Plan MetLaw 1-800-821-6400 www.legalplans.com
Perks and Discounts Abenity Not applicable http://littlebird.abenity.com
Employee Assistance Program AnthemLife 1-888-209-7840 www.ResourceAdvisor.Anthem.com

This 2015 Benefits Catalog is a Summary of Material Modifications (SMM) providing information on various Little Bird benefit plans, including any changes that take effect January 1, 2015. It is intended to provide an overview of the benefit
plans available to you as an eligible employee. If any information in this 2015 Benefits Catalog conflicts with the Plan Documents, certificates, and insurance policies, those Plan Documents, certificates, and insurance policies will govern.
Little Bird reserves the right to amend, modify, or terminate these plans at any time. This 2015 Benefits Catalog does not constitute a contract of employment.

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