Eligibility
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 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.
Summary of Benefits and Coverage (SBC)
Summary Plan Document (SPD)
CBA Blue Documents
JoinHealth
Prescription Drug Information
If there are any questions regarding prescription coverage, please contact RxBenefits:
• Call: 800.334.8134, Monday – Friday 7:00 a.m. to 8:00 p.m. CT
• Email: CustomerCare@rxbenefits.com
• Chat with a live agent via member portal: Member.RxBenefits.com Monday – Friday, 9:00 a.m. to 6:00 p.m. CT
• Pharmacist call the Pharmacy Help Desk: 800.736.3796
Click the link below for the prescription drug list:
Prescription drug list | OptumRx
Click the link below for help locating a pharmacy:
https://welcome.optumrx.com/rxexternal/external-pharmacy-locator?type=PDPClientPharmacy
What is CBA Blue LIVE?
LIVE (also known as telehealth, or telemedicine) is the use of technology to connect with a provider by video or phone using a computer or mobile device.
Employees who are enrolled in the medical plan are automatically eligible for CBA Blue’s Telehealth Connection.
Activate account by going to portal.cbabluevt.com.
- Login or using username and password or by calling 866-453-5228
- Complete Medical Profile
- Dependents and their medical profiles can be added through member portal
- Consultations can be requested by logging in or call the above number, and a doctor will call back within 2 hours.
THE BENEFITS OF VIRTUAL CARE:
- Telehealth Services via phone consultations ($40 per phone consultation).
- No waiting You get connected quickly.
- 24/7, live and on-demand for a variety of minor health care questions and access to care from just about anywhere.
- It’s convenient, for example, talking to a board-certified doctor for a minor medical issue costs less than an ER or urgent care center, and may even be less than an in-office Primary Care Provider (PCP) visit.
Forms and Plan Documents
Simon Pearce offers you several options to help offset your deductible, qualified medical expenses, and/or dependent care expenses.
Simon Pearce offers a Limited Purpose FSA, a General FSA and a DCA, all through CBA Blue.
Limited Purpose FSA: A Limited Purpose Flexible Spending Account (LPFSA) is a pre-tax savings account that can be used to pay for eligible dental and vision expenses. The Limited Purpose FSA allows you to set aside money from your paycheck on a pretax basis to pay for out-of-pocket dental and vision costs.
- Contribution limits: The maximum contribution for an LP-FSA is $3,300 per employee, or $6,600 per household if the employee’s spouse also has an FSA.
- Carryover: The maximum amount that can be carried over to the next year is $660.
Limited Purpose FSA, General Purpose FSA & Dependent Care Account
Health Savings Account (HSA)
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 Basic or HSA 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 Basic or HSA 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 – $4,300
- Family – $8,550
- Catch-up contribution (age 55+) – $1,000
Download the App Today!
Forms and Plan Documents
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 $3,300 annually. The health care FSA includes a rollover provision that allows employees to rollover up to $660 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.
Contributions
Employees contribute funds into their Medical FSA or Dependent Care Account through pre-tax payroll deduction in equal amounts spread over the calendar year.
Forms and Plan Documents
The Richards Group has entered into a partnership with Health-E Commerce, also known as the FSA/HSA Store. This gives you access to hundreds of products that have been pre-vetted & approved for use with your Flexible Spending or Health Savings Accounts.
Did you know you could use your FSA/HSA to save money on everyday health essentials like baby health items, health trackers, pain relief products and more?
Here are just a few benefits of using the FSA/HSA Store:
- No Receipts Needed
- 2,500+ FSA Eligible Products
- 100% Eligibility Guaranteed
- Skip the claims process when you use your FSA/HSA card
To see a complete list of FSA qualified expenses CLICK HERE.
This partnership also allows access to their Caring Mill products. Caring Mill is a line of premium healthcare products that support a healthy lifestyle and on average is priced 30% less than branded equivalent products.
With every Caring Mill purchase, a donation is made to Children’s Health Fund, providing necessary treatments to thousands of children in need, throughout the United States.
Curious what your FSA/HSA dollars can cover? Simply enter the product you are looking for in the eligibility list below.
To access the FSA Store please visit: https://fsastore.com
To access the HSA Store please visit: https://hsastore.com
Additional Information:
|
Eligibility All full-time employees who work at least 20 hours per week are eligible for coverage on the first day of the month following their first day of employment. |
Life/AD&D Insurance
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.
Basic Life/AD&D
(100% Employer Paid)
- Benefit amount is 1 times your prior W2 earnings not to exceed $50,000
- Benefits reduce by 50% at age 70
Forms and Plan Documents
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Eligibility 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 Symetra on themselves and their eligible dependents.
Forms and Plan Documents
Short-Term Disability
(100% Employer Paid)
Employees who work 20 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.
Simon Pearce provides eligible employees with Short Term Disability coverage through Symetra. 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 26 weeks per eligible disability. Partial benefits are available based on the percent of lost base wages and other circumstances.
***Updated Plan Documents will be provided once carrier completes. For questions please see HR***
Additional Plan Information
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 Symetra. Payment of benefits will begin at 26 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.
***Updated Plan Documents will be provided once carrier completes. For questions please see HR***
Additional Plan Information
Accident Insurance & Critical Illness
Employees who work 30 hours or more per pay period are eligible to elect Voluntary Accident and/or Voluntary Critical Illness coverage and are eligible the 1st of the month following date of hire.
Employees working 20-30 hours are eligible to enroll in Employee Only Coverage for Accident and $5,000 in Critical Illness Coverage (Employer Paid).
Employees that enroll in the Basic Plan with CBA Blue will automatically be enrolled in the Employee Only Tier for the Accident Coverage.
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%.
If you have any questions, please use the customer service number or login on the Symetra website.
Accident Insurance Benefits Summary
Critical Illness Benefits Summary
When life gets tough, it’s helpful to have someone in your corner to listen, offer advice and point you in the right direction for additional help. That’s what you get from Disability Guidance SM— an Employee Assistance Program that offers confidential counseling when you need it most.
Program highlights:
You and eligible family members can call to speak with a financial planner or attorney, or meet face-to-face with a counselor for expert, confidential information and guidance. Your household is eligible for a total of five sessions per calendar year, plus an additional five with a covered disability claim. These services are included in the overall premium, so no additional payment is required to use the program.
Common Reasons to reach out EAP:
Stress, anxiety or depression Marital conflicts
Relationships Empty-nesting
Problems with your children Legal issues
Substance abuse Mental health
Grief and loss Workplace conflict
Contact us:
We’re available 24/7 to assist you.
Call: 1-888-327-9573
TDD: 1-800-697-0353
Online: guidanceresources.com
Web ID: SYMETRA
When talking on the phone, mention Symetra as your employer sponsor.
Forms & Plan Documents
Eligibility
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.
Eligibility
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.
Retirement Benefits
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.
Contributions
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
Financial Advisor
Melanie Brown from Hickok & Boardman is available for on-sit consultations and financial advice at NO COST to you.
She can be reached at melanie.brown@hbretire.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.
Additional Information
SmartConnect - Medicare Resource
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:
1-833-502-2747 | TTY: 711
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
Eligibility
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.
GradFin will:
- 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.
Contact Us
GradFin
Phone: (844) GRADFIN
Website: https://gradfin.com/platform/trg/
For more information or to schedule a 15-minute appointment with a GradFin Consultation Expert click HERE!
Forms & Plan Documents