You are eligible for benefits if you work 30 or more hours per week. You may also enroll your eligible family members under certain plans you choose for yourself. Eligible family members include:
- Your legally married spouse (spouse coverage rule applies)*
- Your children who are your natural children, stepchildren, adopted children, or children for whom you have legal custody (age restrictions may apply). Disabled children age 26 or older who meet certain criteria may continue on your health coverage.
*Spouse coverage rule for Medical Plans: spouses are not eligible to enroll in the Simon Pearce Medical plan if they are eligible for coverage through their own employer.
When Coverage Begins
You must complete the enrollment process within 30 days of your date of hire. Coverage is effective on the first day of the month after hire date. If you fail to enroll on time you will NOT have benefits coverage (except for company-paid benefits). Changes made during Open Enrollment are effective at the start of the next calendar year.
Employees cannot make benefit changes during the year unless you have a qualifying event such as:
- Marriage or divorce
- Birth or adoption of a child
- Child reaching the maximum age limit
- Death of a spouse or child
- Change in child custody
- Change in coverage election made by our spouse during their employer’s
- Open Enrollment period
- You lose coverage under your spouse’s plan
To make changes to your benefit elections, you MUST contact Human Resources within 30 days of the Qualifying Event (including newborns). Be prepared to show documentation of the event. If changes are not submitted on time, you must wait until the next Open Enrollment period.
Medical Plan Options
Simon Pearce is pleased to offer you the choice of three (3) plan designs to all eligible employees who work 30 hours or more per week. Employee premium rates may vary based on Part-time (30-35 hours per week) and Full-time (35+ hours/week) status.
- The Bronze Plan is a Qualified High Deductible Health Plan (HDHP). Employees can choose to contribute to a Health Savings Account (HSA).
- The Silver Plan is a Co-Pay Plan.
- The Gold Plan offers a Health Reimbursement Account (HRA) which allows you to use funds to pay for your deductible and coinsurance expenses. Pharmacy expenses cannot be paid with HRA funds. Simon Pearce will contribute to this HRA based upon the level of coverage chosen by each employee.
Summary of Benefits and Coverage (SBC)
Transparency in Coverage – Machine Readable Files
By clicking this link, (Cigna – Machine Readable Files), you will be directed to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
Prescription Drug Information
Please click here for the Cigna Provider Directory
Group Number: 623907 — for use with medical and pharmacy carriers
For more information on the health exchange, please refer to the link below for the state in which you live:
Mothers To Be
Additional Plan Information
Employees are eligible for medical benefits on the first of the month following the first day of employment. Employees and dependents enrolled in any of the Cigna medical plans have access to MD Live and Amwell Telehealth benefits.
What is the Cost?
The Cost of Service will be provided when the visit is scheduled. The cost is the same or less than a visit with your primary care provider.
Cigna Telehealth Connection
Health Savings Accounts
A HSA is a tax-advantaged account that allows employees to save pre-tax dollars to pay for qualified medical expenses. The HSA is administered by Health Equity, Inc. For a list of eligible expenses please visit healthequity.com
To be eligible to enroll in a HSA, you must meet the following requirements:
- You are enrolled in the Bronze Plan.
- You aren’t enrolled in Medicare.
- You can’t be claimed as a dependent on someone else’s tax return.
- You aren’t insured under any other medical plan that is not a HDHP.
- You haven’t received VA benefits (Medical or Rx) during the past 3 months.
Health Savings Account (HSA)
- Employees are eligible to participate in a HSA if they are enrolled in the Bronze Plan.
- The account is 100% employee funded.
- Employees who wish to contribute to a HSA must activate their account through Health Equity by registering online at myhealthequity.com
- Employees will also have to name a beneficiary for their account and call Health Equity, Inc at 866-346-5800 to activate their HSA debit card.
- Contribution Limits:
- Single – $3,850
- Family – $7,750
- Catch-up contribution (age 55+) – $1,000
Flexible Spending Accounts
With a Flexible Spending Account, you can pay for unreimbursed medical, dental, vision and many more health related expenses on a pre-tax basis. You may deduct up to $3,050 annually. The health care FSA includes a rollover provision that allows employees to rollover up to $610 of unused funds into the next plan year.
With Dependent Care Accounts, employees can put away funds for dependent care expenses on a pre-tax basis. The maximum you may contribute to the dependent care FSA is $5,000 (if single or married & filing jointly) or $2,500 (if married and filing separately).
Employees who elect the Bronze Plan and a Health Savings Account may elect a Limited Purpose Flexible Spending Account, which can only be used for dental and vision expenses. This IRS rule is in place to help avoid “double dipping” since the HSA can also be used for medical, dental and vision expenses. For more information, please click on the links below.
To see a complete list of FSA qualified expenses CLICK HERE.
Employees contribute funds into their Medical FSA or Dependent Care Account through pre-tax payroll deduction in equal amounts spread over the calendar year.
All full-time employees who work at least 30 hours per week are eligible for coverage on the first day of the month following their first day of employment.
Life Insurance provides your named beneficiary with a benefit in the event of your death.
Accidental Death and Dismemberment (AD&D) Insurance provides specified benefits to you in the event of a covered accidental bodily injury that directly causes dismemberment (ie. loss of a hand, foot, or eye). If you death occurs due to a covered accident – both the Life and the AD&D benefit would be payable.
(100% Employer Paid)
- Benefit amount is 1 times your prior W2 earnings not to exceed $50,000
- Benefits reduce by 50% at age 70
Employees who work 30 hours or more per pay period are eligible for Voluntary Benefits and coverage effective on the first of the month following their first day of employment.
Voluntary Life and AD&D Benefits
(100% Employee Paid)
Eligible employees may purchase Voluntary Life and Accidental Death and Dismemberment (AD&D) coverage through Reliance Standard Life Insurance (RSLI) on themselves and their eligible dependents.
(100% Employee Paid)
Employees who work 30 hours or more per pay period are eligible for Short Term Disability Insurance on the first of the month following their first day of employment.
Employees have the opportunity to purchase Voluntary Short-Term Disability Insurance. This benefit begins on the 1st day of a qualified disability due to injury or on the 8th day of a qualified disability due to illness. The benefit is 60% of prior year W2 earnings to a maximum of $750 per week. The maximum benefit period is 13 weeks per eligible disability. Partial benefits are available based on the percent of lost base wages and other circumstances.
Long Term Disability
(100% Employer Paid)
Employees who work 30 hours or more per pay period are automatically enrolled in Long Term Disability Insurance on the first of the month following their first day of employment.
Simon Pearce provides eligible employees with Long Term Disability coverage through RSLI. Payment of benefits will begin at 13 weeks from the start of a qualified disability. The plan pays 60% of prior year W2 monthly earnings up to a maximum of $5,000 per month. Benefits are payable up to age 65 if disability begins prior to age 60, and as long as the employee remains disabled. Partial benefits are available when earnings are less than 80% of basic monthly pay.
Critical Illness & Accident Insurance
(100% Employee Paid)
Employees who work 17.5 hours or more per pay period are eligible to elect Voluntary Accident and/or Critical Illness coverage and are eligible the 1st of the month following date of hire.
These plans are designed to provide a continuation of benefits to you in the event of either sickness or accident.
Please note that those aged 70 years or older are ineligible to enroll in the accident plan and also at age 70, the critical illness benefit reduces by 50%.
Simon Pearce provides all employees with an Employee Assistance Program (EAP) through Reliance Standard and ACI Specialty Benefits. EAP is a confidential resource that you can access when you need someone to talk to-about a family matter, stress, or a personal problem of any kind.
The ACI consultants are available 24 hours a day, 7 days a week, 365 days a year. Whether you’re dealing with an issue at work or at home or simply looking for ways to take better care of yourself and your family, you can turn to Work-Life Balance for support. All employees and members of their household may utilize up to three sessions of assessment, referral, and/or short-term problem solving per assessed problem per year at no cost to the employee.
ACI provides a national network of experienced, professional counselors who can help you, no matter where you are or what kind of situation you are facing. When you call the program, you can discuss your concerns with a consultant who will connect you with an appropriate counselor in your local area. You will be offered an appointment within a few business days.To speak with an ACI consultant, call 855-775-4357.
On-line help is also available on the myACI online website where you can watch short videos, listen to podcasts, read or download hundreds of articles, access CDs and booklets, email a consultant, and more.
- Personal/Relationship/Family Issues
From dealing with stress, addiction, grief, midlife issues, to caring for older relatives, raising safe and responsible kids-EAP consultants can help.
- Financial Health
Talk with a financial consultant to learn how to get out from under your debts, save and invest for the future, or simply make ends meet.
- Legal Health
If you have legal questions, Work-Life Balance legal services offers access to on-staff attorneys for free 30-minute legal consultations and referrals to low-cost and no-cost public community legal resources and local attorneys whom you can contact for a free 30-minute consultation on the phone or in person.
The Simon Pearce EAP through ACI is a confidential service. No one will know if you use the EAP-not your supervisor, Simon Pearce, or your family members. And any information you provide to ACI is confidential and cannot be shared without your explicit consent.
Forms & Plan Documents
All employees enrolled in a medical plan with Simon Pearce are eligible to utilize Health Advocate services.
Health Advocate Benefits
Simon Pearce provides this service free to employees. Employees can receive assistance from Health Advocate with understanding claims, working with providers, finding appropriate providers and many other services. This service is 100% confidential.
Simon Pearce encourages employees to save for their retirement. All employees who are 18 years of age are eligible to participate in this plan on the first of the month following the first day of employment.
The Simon Pearce 401(k) Retirement Plan offers several different investment options within the fund group. There are 2 components to the retirement plan:
- 401(k) plan: Eligible employees can defer from their paycheck on a pretax and/or after tax basis up to 50% of their eligible earning up to the IRS maximum. Participants are always 100% vested in this money.
- Simon Pearce matches contributions with each pay period. Details of the match and vesting schedules can be found with the 401k enrollment packet provided during onboarding.
For more information, or to get started visit your employee website at: my.vanguardplan.com
From here you will be able to choose statement delivery preference (default is paperless), enter beneficiary information and opt-in for automatic account rebalancing.
Employees may contribute up to the IRS annual maximum into this retirement plan.
Want to Learn More?
Click on the image below to view a short informative video on Simon Pearce’s 401(k) Retirement Plan
Forms and Plan Documents
Melanie Brown from Hickok & Boardman is available for on-sit consultations and financial advice at NO COST to you.
She can be reached at email@example.com or 802-488-8715
From investment advice to outside money management, H &B has the knowledge, tools, and resources to help make your financial goals come true.
The Richards Group has partnered with SmartConnect™, an exclusive, no-cost program created specifically to connect Medicare-eligible working adults to the world of Medicare benefits. Whether you plan to continue working or are transitioning to retirement, SmartConnect tailors solutions designed around your needs. Agents will provide an unfiltered view of the entire range of options and prices available.
SmartConnect Contact Information
Additional Information & Resources
Upcoming Event: SmartConnect Medicare Webinars
My Time Off Benefits
Simon Pearce recognizes the importance of providing employees with Work /Life balance. Since many of our locations are open on weekends and holidays, we combine our paid vacation, personal, and sick days into one category called “PTO” (Paid-Time-Off). We encourage all of our employees to use their paid time off for the rest and relaxation that is well deserved.
PTO Tiers Chart
For more info please see the document that correlates to your position
My Additional Benefits
In order to participate in the plan, you must satisfy certain age and service conditions under the plan:
1. Minimum age requirement: In order to participate in the plan, you must be at age 21.
Student Loan Assistance
The Simon Pearce student loan consolidation program is designed to help Simon Pearce employees pay back student loan debt and improve their financial well-being.
Utilizing Simon Pearce’s relationship with The Richards Group, consultation services provided through GradFin are provided free of charge. GradFin is a new employee benefit program that is revolutionizing the way employees can reduce their student loan debt.
- Provide one-on-one education consultations with GradFin Consultation Experts to review your current loan status and discuss personalized payoff options to save on your loans.
- Offer a competitive interest rate reduction when you refinance your loans.
- Provide up to a $300 bonus to you when you refinance your loans with GradFin. The $300 bonus will be applied to the principal balance of the closed loan.
- Offer the lowest interest rates in the industry through their lending platform which is made up of ten lenders to maximize the chances that you will be approved for a new loan.
Forms & Plan Documents