In-Network Benefits | Open Access Plus PPO | Local Plus PPO | HDHP HSA |
---|---|---|---|
Preventive Care | Plan pays 100% | Plan pays 100% | Plan pays 100% |
Annual Deductible | $750 (I) / $1,500 (F) | $1,250 (I) / $2,500 (F) | $1,500 (I) / $3,000 (F) |
Out-of-Pocket Max | $4,000 (I) / $8,000 (F) | $5,000 (I) / $10,000 (F) | $3,000 (I) / $6,000 (F) |
Primary Care / Specialist Visit | $30 copay/visit, deductible does not apply $50 copay/visit, deductible does not apply |
$30 copay/visit, deductible does not apply $50 copay/visit, deductible does not apply |
$30 copay $50 copay |
Urgent Care / Emergency Room | $55 copay $100 copay + 20% coinsurance |
$55 copay $250 copay + 20% coinsurance |
You pay 20% after deductible |
Lab Work & Diagnostic Tests | No charge | No charge | You pay 20% after deductible |
Semi-monthly Premium
Employee-Only Employee + Spouse Employee + Child(ren) Family |
$130.75 $312.22 $284.12 $454.58 |
$64.37 $205.35 $186.73 $298.45 |
$91.50 $215.20 $194.71 $307.43 |
Pharmacy
Generic (Retail/Retail 90/Mail) Preferred Brand (Retail/ Retail 90/Mail) Non-Preferred Brand (Retail/ Retail 90/Mail) |
$10/$20/$20 copay $45/$90/$90 copay $65/$130/$130 copay |
$10/$20/$20 copay $45/$90/$90 copay $65/$130/$130 copay |
$10/$20/$20 copay $45/$90/$90 copay $65/$130/$130 copay |
Summary of Benefits and Coverage
Summary of Benefits and Coverage (Spanish)
Benefit Summaries
Benefits Summaries (Spanish)
Benefits Booklets
Other Documents
Formulary
Aetna
Kaiser
The ACA requires all businesses with 100 or more full-time equivalent employees (FTEs) to offer health insurance to their full-time workers (working 130 hours of service in a calendar month) or pay a penalty. In addition, the Company must continue to provide access to quality health insurance at an affordable cost.
Included in your W-2 income or subject to income taxes.
Not included in your W-2 income or subject to income taxes.
A person or persons you name – using a form accepted by the plan administrator or insurance carrier – to receive benefits in the event of your death.
A drug that is patented by the FDA and subject to an exclusivity agreement that allows the company to be the sole manufacturer of the drug for a certain number of years.
The percentage that you pay of a covered service.
A fixed dollar amount that you pay for a covered service at the time the service is provided.
The health care services that a plan will cover in part or in full based on plan documents.
The amount you pay for covered services in a plan year before the plan begins to pay benefits.
The day on which you’re eligible to participate in a Your Benefits plan.
Expenses incurred for a covered service.
A statement of proof of a person’s physical condition, occupation, or other factor affecting his or her acceptance for insurance coverage.
A drug that’s considered a “preferred choice” based on its effectiveness and cost.
A prescription drug that has the same active ingredients as a brand-name drug and is subject to the same FDA standards for quality, strength, and purity as its brand-name counterpart, but typically costs less. Not all brandname drugs have generic equivalents.
A Jack in the Box or Qdoba employee or eligible dependent who didn’t enroll in the benefit plan when first eligible to join.
Any licensed doctor, hospital, lab, or other health care provider that has contracted to provide members with comprehensive services at discounted rates.
A brand-name drug that isn’t on a plan’s formulary list.
A brand-name drug that isn’t on a plan’s preferred list.
The maximum amount you pay each plan year for covered services. Once you reach your out-of-pocket maximum, the plan pays 100% for additional covered services.
Any licensed doctor, hospital, lab, or other health care provider that is not part of a provider network.
October 1 through September 30.
A drug that’s considered a “preferred choice” based on its effectiveness and cost.
A doctor within an HMO network whom you’ve selected to coordinate your medical care.
A life event that may allow you to make certain changes to your health plan coverage. This includes marriage, registration of a domestic partnership, legal separation, or divorce; birth, adoption, legal guardianship, or change in custody for a dependent child (or children); the ineligibility or death of a dependent; a move to an area where your current plan isn’t offered; a change in your or your spouse’s employment; or a significant change in health coverage.
The maximum amount the plan will pay for a service, based on what providers in that geographic area charge for similar services or supplies.
In-Network Benefits | Open Access Plus PPO | Local Plus PPO |
---|---|---|
Pharmacy
Generic (Retail/Retail 90/Mail) Preferred Brand (Retail/ Retail 90/Mail) Non-Preferred Brand (Retail/ Retail 90/Mail) |
$10/$20/$20 copay $45/$90/$90 copay $65/$130/$130 copay |
$10/$20/$20 copay $45/$90/$90 copay $65/$130/$130 copay |
MedImpact
In-Network Benefits | Dental HMO | Dental PPO |
---|---|---|
Preventive Services | Plan pays 100% | Plan pays 100% |
Cleanings | 2 per year | 2 per year |
Deductible | None | $150 (I) / $300 (F) |
Calendar Year Maximum | N/A | $1,000 |
Basic Services | Copay schedule | 65% after deductible |
Major Services | Copay schedule | 50% after deductible |
Orthodontic Services | Copay schedule | 50% no deductible |
Orthodontia Lifetime Max | N/A | $2,000 |
Semi-monthly Premium
Employee-Only Employee + Spouse Employee + Child(ren) Family |
$4.18 $8.36 $9.41 $13.59 |
$8.16 $16.32 $18.23 $26.52 |
Aetna
In-Network Benefits | Standard Vision PPO |
---|---|
Eye Exam | $25 copay |
Single Vision | 100% after Copay |
Bifocals | 100% after Copay |
Trifocals | 100% after Copay |
Lenticular | 100% after Copay |
Frames | Up to $170 every 12 months - NEW! |
Contact Lenses | $150 |
Semi-monthly Premium
Employee-Only Employee + Spouse Employee + Child(ren) Family |
$5.60 $7.88 $8.43 $13.49 |
Aetna
HSAs are savings accounts funded by pre-tax contributions from your paycheck. These accounts
earn interest tax free and can be used to help pay for a wide range of medical,
prescription, dental and vision expenses.
The money in this account is yours and rolls over from year to year. You can save it or
use it for qualified expenses now or anytime in the future. It’s also portable, so if you
retire or leave Casanova/McCann, you can take it with you.
✓ Contributions are pre-tax and are automatically deducted
✓ Funds rollover from year-to-year and are yours to keep
✓ Catch-up contributions are for those aged 55 and older
PayFlex
An FSA saves you money by reducing your income taxes. You must choose how much to contribute
each year, up to the stated limit. Your FSA contributions are automatically deducted from
your pay BEFORE any taxes are calculated, and are not reported as income to the IRS. The FSA
plan is effective January 1 to December 31 (calendar year).
Existing employees may
enroll during Open Enrollment. New Hires must fulfill their eligibility requirements prior
to enrolling.
✓ Contributions are pre-tax and are automatically deducted
✓ Funds do not rollover from year-to-year
A health savings account, or HSA, is an account that’s funded with pre-tax contributions from your paycheck and used to cover health-related expenses. f
✓ Contributions are pre-tax and are automatically deducted
✓ Funds do not rollover from year-to-year
PayFlex
The company provides a benefit of 1x base salary up to $250,000 of Basic Employee Life insurance for all eligible employees.
✓ You are automatically enrolled
✓ Be sure to have an updated beneficiary form on file
✓ Benefit reduces to 65% at age 65 and 50% at age 70
If you want additional protection for you and your family, you have the option to buy Supplemental Life Insurance as shown below. Note that you must elect Supplemental Life Insurance for yourself in order to purchase coverage for your dependents.
✓ Employee Life:Increments of $10,000 from $10,000 up to $500,000
✓ Spouse Life: Increments of $5,000 from $5,000 up to $100,000
✓ Child(ren) Life: $1,000, $2,000, $4,000, $5,000 or $10,000 coverage amounts available
✓ Guarantee Issue $150,000, Spouse - $25,000, Child – N/A (EOI not required)
If you’re suddenly unable to earn a paycheck due to illness or an accident, short term disability insurance through your employer can replace a portion of your income during the initial weeks of your disability.
✓ You are automatically enrolled
✓ The Disability plans pay 60% of weekly earnings up to $2,500
✓ Up to 26 weeks of coverage
✓ Coverage begins on the first day of disability caused by an accidental injury or after 7 days of disability caused by physical disease, pregnancy or mental disorder
Long term disability insurance through your employer can provide a steady stream of income to help cover essential expenses during an extended illness or after a disabling accident.
✓ You are automatically enrolled
✓ 50% of your base monthly earnings up to $5,000 paid
✓ Coverage begins after 180 days of disability
✓ Buy-up coverage available | Additional 10% of coverage of base monthly earnings up to $10,000
MetLife
We have added Chubb’s Lifetime Benefit Term Life plan, which provides coverage through your lifetime at a fraction of the cost of permanent life insurance. Flexibility allows you to customize benefits for long term care.
Choose between Basic Benefit Amounts of up to $10,000, $15,000, or $30,000 payable at time of diagnosis of included Critical Illnesses.
On-or-off-the-job protection. The High Plan includes $1,500 for Hospital Confinement, $75 for Outpatient Physician, & up to $500 for Medical Expenses.
Hospital Indemnity coverage picks up where other insurance leaves off and provides cash to help cover hospital expenses.
Casanova/McCann Group, LLC (Casanova/McCann) permits Insurers to offer employees of Casanova/McCann certain voluntary insurance programs. Whether you choose to enroll in any of these programs is completely optional and voluntary. Casanova/McCann does not make a contribution towards the cost of these programs and employees pay the full cost of premiums on an after-tax basis. Casanova/McCann does not sponsor, maintain, endorse, recommend, or promote these voluntary programs. Casanova/McCann’s involvement regarding these voluntary insurance programs is strictly limited to allowing the insurer access to employees to publicize these programs and Casanova/McCann may perform certain ministerial functions such as payroll deduction and forwarding employee premium payments to the insurer. Casanova/McCann does not receive any consideration in the form of cash or otherwise in connection with the program, other than reasonable compensation, excluding any profit, for administrative services actually rendered in connection with payroll deductions. Accordingly, these voluntary insurance programs are not subject to ERISA and related regulations. All questions or claims regarding these programs should be directed to the insurer.
Transamerica
MetLife
Be Sure to Designate a Beneficiary: You can set up your beneficiary information by
going to www.401k.com or by calling a
Principal Representative at 800-547-7754. Simply
request a Designation of Beneficiary Form to fill out and return to Principal.
We offer the chance to build your investment portfolio by purchasing Casanova/McCann stock
at a
discounted rate.
Eligibility:
You are eligible to purchase company stock during the first offering period after six months of employment. Offerings happen twice a year in January and July.
Enrollment:
You may enroll at any point after becoming eligible.
As a Casanova/McCann employee you receive perks and discounts on more than 900 local and
national
merchants like Apple, Samsung, Sprint, Six Flags, and Disney.
Whether it’s greater discount percentages or benefits like free shipping, this exclusive
benefit can help you get more for your money! Plus, PerkSpot includes a newly released
Travel Feature with exclusive discounts up to 60% on hotels in hundreds of destinations
worldwide.
We proudly introduce paid parental leave. From our family to yours, time to bond with your bundle!
For Primary Caregivers:
Up to 12 weeks of paid leave at 100% of your base pay
For partners:
Two weeks of paid leave at 100% of your base pay
Enrolling in this program is an important first step toward a healthy future for you and your baby. All Cigna Healthy Pregnancies, Healthy Babies services are confidential, and your private information will not be shared with Casanova/McCann.
Plan for a Healthy Pregnancy:
When you enroll before becoming pregnant, we can help you be as healthy as possible. You’ll have access to preconception planning tools and resources, including information from the March of Dimes on eating right, maintaining a healthy weight, taking prenatal vitamins, stopping alcohol and tobacco use, and controlling any medical conditions you may have.
Support During Your Pregnancy:
Tell Cigna about your pregnancy so they can meet your needs. You can ask them anything – your coach, who has a nursing background, is there to support you during your whole pregnancy. You’ll even get a pregnancy journal with information, charts, and tools to help you have a happy nine months.
Start Now:
Cigna can help you stay healthy before and during your pregnancy and in the days and weeks following your baby’s birth. Call 800-615-2906 to enroll today. Download the new app by searching for “Cigna Healthy Pregnancies” in the App Store to get support through your entire pregnancy with tips and tools.
Many physical conditions can worsen with stress, substance use, and other behavioral health
issues. Cigna’s whole-person approach provides help with life events, dedicated support,
lifestyle coaching, and online tools.
Virtual Behavioral Care:
Use your smartphone, tablet, or computer for online video conferencing. And your out-of-pocket cost is the same as a behavioral health outpatient office visit. Visit myCigna.com > Find Care & Costs > Doctor by Type > Behavioral Health Counselor > Virtual Counselor to find a provider.
iPrevail:
On-demand coaching and personalized learning with iPrevail is offered at no cost to you. Learn how to boost your mood and improve mental health with on-demand coaching 24/7. You can work with a peer coach and get access to support communities focused on stress, anxiety, depression, and more. Visit iprevail.com/cigna to sign up and download the free app.
Happify:
Science-based activities and games for stress and worries offered in partnership with Cigna. Happify’s activities and games are designed to help you overcome life’s challenges and can be accessed at any time. Visit happify.com/cigna to sign up and download the free app.
Our FREE and confidential Employee Assistance Program
(EAP) helps you find balance between work and home life. Your EAP benefits cover five
sessions of counseling at no cost to you. If you are interested in counseling, you have
three
choices available: face-to-face counseling, secure video counseling, or scheduled telephone
counseling sessions which are available early morning, late in the evening, and on
weekends.
If you choose to continue to see the counselor beyond the initial sessions, you may be able
to use your health insurance benefits for more long-term coverage.
Casanova/McCann offers this program to you and your immediate family (spouse or domestic
partner,
dependent children up to age 26) at no cost to you.
✓ Marriage and family problems
✓ Job-related issues
✓ Stress, anxiety and depression
✓ And more!
Get immediate access to specialized professionals in counseling, social work, human services and psychology. You have access to the LifeWorks network of thousands of master’s level counselors and affiliates.
✓ Get support with financial and legal issues
✓ Receive 5 free appointments included in your Niagara benefits
✓ Enjoy hassle-free scheduling with LifeWork's easy-to-use app
LifeWorks