1.1.20 HSS Benefit Summary
1.1.20 HSS Benefit Summary
Hospitality Staffing
Solutions
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Medical Insurance | Anthem of GA
Preferred Provider Organization (PPO)
A PPO plan offers the freedom to receive care from any in- or out-of-network doctor, specialist or hospital without a
referral. You have a deductible to meet and once the deductible is met, coinsurance (or the cost share between you
and the carrier) kicks in. The types of medical services that accumulate towards your deductible are inpatient hospital
stays, outpatient surgeries, labs (blood work) and x-rays (MRIs, PET scans, CT scans, etc.). If you go to the doctor,
see a specialist, utilize the ER or take a prescription drug, you’ll pay a copay for those specific services. Copays do not
accumulate towards your deductible but they do accumulate towards your overall out-of-pocket maximum.
High Deductible Health Plan (HDHP) with Health Savings Account (HSA)
This medical plan option is comprised of two components (1) a High Deductible Health Plan (HDHP) and (2) a
tax-exempt savings account called a Health Savings Account (HSA).
The HDHP is a high deductible PPO plan that provides health care benefits after the deductible has been met. All
medical services, with the exception of preventive care, are paid for by you at 100%, less carrier discounts, prior to
meeting your entire annual deductible. This includes routine office visits, procedures, lab work, prescription drugs, etc.
The HSA is a bank account paired with your HDHP allowing you to set aside money on a tax-free basis to pay your
out-of-pocket qualified medical, dental, and vision expenses throughout the year or in the future. You own the money
in your HSA account and it is yours to keep – even when you change plans or retire. The funds roll over from year to
year to be used when you really need them.
Choice of plan options: $250 PPO $500 PPO $1,500 PPO HDHP with HSA
Deductible
Individual
(In-Network / Out-of-Network) $250 / $500 $500 / $1,000 $1,500 / $3,000 $2,800 / $8,100
Family
(In-Network / Out-of-Network) $500 / $1,000 $1,000 / $2,000 $3,000 / $6,000 $5,600 / $16,200
Coinsurance
90% / 70% 80% / 50% 80% / 50% 80% / 50%
In-Network / Out-of-Network
Out-of-Pocket Max
Individual
(In-Network / Out-of-Network) $2,000 / $4,000 $3,000 / $4,000 $4,000 / $5,000 $5,000 / $15,000
Family
(In-Network / Out-of-Network) $4,000 / $8,000 $6,000 / $8,000 $8,000 / $10,000 $10,000 / $30,000
Emergency Room $150 copay $150 copay $150 copay Deductible then 80%
Urgent Care (In-Network) $75 copay $75 copay $75 copay Deductible then 80%
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Medical Insurance Rates
$250 PPO $500 PPO
Bi weekly Bi weekly You Pay
You Pay
Contributions: Contributions:
Employee Only $75.01 Employee Only $58.24
Employee & Spouse $233.39 Employee & Spouse $202.94
Employee & Child(ren) $184.77 Employee & Child(ren) $155.95
Family $316.75 Family $278.00
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Dental Insurance
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Dental Insurance | MetLife
Preferred Provider Organization (PPO)
These dental plans allow the flexibility to select any dentist in-network or out-of-network. By staying in-network, the
contract between your dentist and insurance carrier will make your annual benefit period maximum last longer.
Dental coverage focuses on preventive and diagnostic procedures in an effort to avoid more expensive services
associated with dental disease and surgery. The type of service or procedure received determines the amount of
coverage for each visit. Each type of service fits into a class of services according to complexity and cost.
High PPO
Bi weekly You Pay
Contributions:
Employee Only $9.83
Employee & Spouse $19.67
Employee & Child(ren) $20.47
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
Family $32.28
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Vision Insurance
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Vision Insurance | MetLife
Vision insurance helps offset the costs of routine eye and also helps pay for vision correction eye wear,
eyeglasses and contacts, that may prescribed by an eye-care
accessing in-network vision providers, able to reap the benefit of true vision insurance coverage.
eligible for an eye exam and lenses or contact lenses every months and frames every 24 months.
Out-of-network providers merely offer you allowance towards your vision
Frames
Elective Contacts
Lenses
- Single vision
- Bifocal Every 12 months* $20 copayment Allowance varies
- Trifocal
- Lenticular
Frames Every 24 months* $150 allowance $70 max allowance
Elective Contacts Every 12 months** $150 allowance $105 max allowance
*Vision benefit frequencies are based on the date of service within the policy year
** You cannot get contacts and glasses in the same calendar year
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Basic Life and AD&D Insurance
Basic Life Insurance helps ease your loved ones’ financial burden. Your designated beneficiary will receive a benefit
if you pass away from a covered accident or illness. In addition, Accidental Death and Dismemberment (AD&D)
provides a benefit to your beneficiary if you pass on or become dismembered due to a specifically covered accident.
Basic Life/Accidental Death Class 1: Officers & VP’s Class 2: All other FT employ-
& Dismemberment ees
Benefit Amount 3x BAE per employee - Life 1x BAE per employee - Life
3x BAE per employee - AD&D 1x BAE per employee - AD&D
The cost of the benefit is 100% paid for by you. Your age and the amount of insurance you elect determines the
premium you’ll pay. Costs will go up as you age. See your plan documents for more detail.
**If you choose coverage after the initial enrollment you will be limited to a $100 weekly benefit amount at the
next annual enrollment. At subsequent annual enrollments you will be limited to increasing your weekly
benefit coverage
NOTE: This byis $50.
Benefit Highlights merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Employee Assistance Program (EAP)
EAP service offers caring and professional assistance for a broad range of concerns including stress management,
depression and anxiety, relationship or family conflicts, workplace conflicts, legal or financial difficulties, and drug or
alcohol abuse. Services are confidential - neither your employer nor co-workers have knowledge of your request for
help. EAP services are available 24 hours a day, seven days a week for you and your eligible dependents. There
is no cost, it’s just there for you when you need it.
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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+
Critical
Critical Illness Insurance | MetLife
can help safeguard your finances by providing you with a payment when your
family needs it most. The payment you receive is yours to spend as see fit, in addition to any other
insurance you may
you meet the policy requirements, Critical insurance provide you with a sum payment upon
diagnoses f o r man y
Coronary Artery
100% of Benefit 50% of Benefit
Major Organ
100% of Benefit Not
Transplant Benefit
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Accident Coverage | MetLife
Accident insurance coverage provides you with payment for a covered accident. It also pays if you undergo testing,
receive medical services, treatment of care for any one of more than 150 covered events as defined in your group
certificate. This includes hospitalization resulting from an accident and accidental or dismemberment.
Payments are made directly to you as you see fit. They can be used to help pay for medical plan deductibles and
copays (if applicable), out-of-network treatments, your family’s everyday living expenses or whatever else you need
while recuperating from an accident.
As added incentive to staying well, after coverage has been in place for 30 days, you will be provided an annual
benefit of $50 per calendar year for taking one of the eligible screening/preventive measures that take place during
your no cost preventive care exam.
Injuries
Fractures $50-$3,000 $100-$6,000
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Carrier Information
Medical PPO Vision
Carrier Anthem of GA Carrier MetLife
Website www.bcbsga.com Website www.metlife.com
Phone Number 800-441-2273 Phone Number 800-474-7371
Network PPO Policy Number 05925066
Policy Number GA8864
Medical HDHP/HSA Basic Life and AD&D Insurance
Carrier Anthem of GA Carrier MetLife
Website www.bcbsga.com Website www.metlife.com
Phone Number 800-441-2273 Phone Number 800-474-7371
Network PPO
Policy Number GA8864
Dental PPO Voluntary Term Life and AD&D Insurance
Carrier MetLife Carrier MetLife
Website www.metlife.com Website www.metlife.com
Phone Number 800-474-7371 Phone Number 800-474-7371
Policy Number 05925066
Carrier MetLife
Website www.metlife.com
Phone Number 800-474-7371
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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+ Anthem Value Added Benefits
www.anthem.com 24/7 Nurseline: 800.337.4770
A secure member website that gives you immediate General health info and guidance for specific conditions
access to health care benefit information. Here you from fevers to bee stings from a registered nurse.
can check claim status, find in-network providers, use
the hospital comparison tool, and much more. Maternity Care Program: 800.828.5891
Personalized support provided by Obstetrical nurses.
Sydney Health app
Access your account from a mobile device. Opt in to Health Rewards - Earn up to $200 in rewards
receive texts for Rx refill reminders, diet and fitness It’s easy to get started. Here’s how:
tips, claim updates and more. Download the app for 1. Register or log into Anthem.com
immediate access. 2. Once you’re logged in, go to the Health & Wellness
section
Virtual Visits—LIVEHEALTH ONLINE 3. Select Get My Rewards.
LIVEHEALTH’s telehealth program provides enrolled
members with access to non-emergency medical care You’ll be taken to the Anthem Health Rewards site, where
without even leaving the couch. Visit a doctor virtually you can view activities and start earning rewards. See in-
24 hours a day, 7 days a week for a variety of different side to learn more
ailments and symptoms. Log on to anthem.com or call
888.548.3432 today to find out additional info on this
awesome benefit.
Prescription Drugs
• Ask your doctor if there’s a generic version of any medication you’re currently taking or being prescribed
• Take advantage of the Prescription Savings Programs at major retailers
• Ask about free samples from your doctor and/or manufacturer rebates
• Doctor’s office: for symptoms that aren’t life threatening, call and let them know your symptoms require immediate
attention
• Convenient Care Clinics: use when you don’t have a primary doctor or can’t get an appointment. Good for fever,
sore throat/strep, coughs/congestion, sports physicals, UTIs, etc. Visit cvs.com or walgreens.com to find a clinic
near you*
• Urgent Care (UC): less costly than the ER; can treat sprains/strains, minor breaks, mild asthma, minor
infections, rashes, small cuts, burns, etc.
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Notes
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Notes
NOTE: This Benefit Highlights is merely intended to provide a brief overview of Centro’s employee benefit programs. Employees should review Centro’s current employee handbook and ac tual
plan documents for the precise terms of such programs. In the event of any inconsistency between this Summary of Benefits and such governing documents, the governing documents will control.
Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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Brought to you by:
NOTE: This Benefits Summary is merely intended to provide a brie f overvie w of the Company’s employee benefit programs. Employees should review the Company’s employee
handbook and actual pla n documents for the precise terms of such programs. In the event of any inconsistency between this Be nefits Summary and such governing documents, the
governing documents will control. The Company reserves the sole and absolute discretion and right to interpret, apply, amend , discontinue or terminate, without prior notice, any and all of
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Centro reserves the sole and absolute discretion and right to interpret, apply, amend, discontinue or terminate, without prior notice, any and all of the benefit programs referenced herein.
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